Rapid progression of a small penetrating aortic ulcer to rupture in the setting of Staphylococcus aureus bacteraemia.
Agnieszka Mijalska, Sylwia Barańska, Mateusz Jadeszko et al.
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Case in brief
An octogenarian woman with a history of heart failure and atrial fibrillation presented with cervical phlegmon and Staphylococcus aureus bacteraemia. Initial CT angiography revealed a small penetrating aortic ulcer, prompting conservative management. However, three weeks later, she experienced acute abdominal pain and anaemia, leading to a repeat CT that showed a contained rupture. Emergency endovascular repair was successfully performed, and she remained stable at 18-month follow-up.
Diagnostic / clinical pearl
Clinicians should be vigilant for rapid progression of aortic ulcers, especially in patients with concurrent infections, as this can lead to acute complications requiring urgent intervention.