Uncorrected Preoperative Infection Causing the Death of a Patient with a Thoracic Aortic Aneurysm

Abstract

Background

A thoracic aortic aneurysm (TAA) is a known condition seen in cardiovascular practice. A TAA rupture and postoperative infection may result in death. Preoperative infections leading to death are extremely rare.

Case Study

A 62-year-old Chinese female was admitted to The First Hospital of Hebei Medical University with a two-day history of abdominal pain. She was diagnosed with a TAA rupture and underwent immediate surgery. The preoperative urine analysis indicated that the positive bacteria and white blood cell count suggested a urinary tract bacterial infection. The patient was administered the empiric antibiotics, cefazolin; however, her blood pressure continued to drop during the perioperative period and she died of uncorrectable acidosis 8 h after the operation. On the second day after death, both the blood and urine cultures were positive for Pseudomonas aeruginosa.

Conclusion

Given that this patient with a TAA rupture died of uncorrected acidosis caused by preoperative infection, it is important to evoke the diagnosis in the context of TAA. Routine laboratory indicators are valuable factors for surgeons and physicians in assessing a patient’s condition and improving their prognosis.

Keywords:

• thoracic aortic aneurysm
• infection
• sepsis
• acidosis
• urine routine
• emergency surgery
• empirical medication
• Pseudomonas aeruginosa

Abbreviations

TAA, Thoracic aortic aneurysm; AA, aortic aneurysms; PLT, platelet; ALT, alanine aminotransferase; AST, aspartate aminotransferase; GGT, gamma-glutamyl transpeptidase; ALP, alkaline phosphatase; PT, prothrombin time; APTT, activated partial thromboplastin time; TT, thrombin time; NT-proBNP, N-terminal pro-B type natriuretic peptide; TnI, troponin I; CK, creatine kinase; CT, computed tomography; CTA, computed tomography angiography; PCT, procalcitonin; IL, interleukin.

Data Sharing Statement

The data generated or analyzed during this study are available in this published article.

Ethics Approval and Consent to Participate

All procedures performed were in accordance with the Declaration of Helsinki. This report was approved by the Ethics Board of The First Hospital of Hebei Medical University (No.2022414). Written informed consent to participate in this report was obtained from the patient’s legal husband because she was died.

Consent for Publication

The patient’s legal husband provided written informed consent for publication because she was died.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

Natural Science Foundation of Hebei Province (No. H202120603).