Infection and Drug Resistance (Jan 2023)
Brucella Infectious Aneurysm: A Retrospective Study of 14 Cases and Review of the Literature – Case Report and Literature Review
Abstract
Lin Wang,1 Yan Wang,1 Tongqiang Ma,2 Jianwei Yuan,1 Hongxia Wang,1 Yuan Ren,3 Jianwei Zhang1 1Department of Infection, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China; 2Department of Vascular Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China; 3School of Public Health, Shanxi Medical University, Taiyuan, People’s Republic of ChinaCorrespondence: Yan Wang, Department of Infection, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China, Tel +8613513635015, Email [email protected]: To analyze the clinical characteristics and treatment process of 14 patients with aneurysm due to brucellosis, summarize the morbidity characteristics, and improve the knowledge and diagnosis of the disease.Methods: The clinical data of patients with aneurysms who were diagnosed to have brucellosis through Rose Bengal Test (RBT), Serum Agglutination Test (SAT), blood culture, and computed tomography angiography from January 2012 to November 2022 in Bethune Hospital, Shanxi Province, China, were retrospectively analyzed, and their clinical characteristics and disease regression findings were summarized.Results: Of the 14 patients, 13 were men, and 1 was a woman; the youngest patient was 48-year-old, and the oldest patient was of 74 years. All had a history of smoking. The sites of lesion occurrence included the abdominal aorta (5 patients), abdominal aorta +iliac artery (5 patients), iliac artery (2 patients), thoracic aorta and brachial artery were less common (1 case each). Symptoms in the patients mostly began with abdominal pain, which was accompanied by fever, nausea, and vomiting. Six patients had a clear history of livestock exposure. Fourteen patients showed elevated D-dimer and C-reactive protein levels and decreased hemoglobin and albumin levels. Thirteen of the 14 cases were treated surgically, there were no complications of surgery, and 3 patients were readmitted with recurrence of brucellosis, it is related to the treatment that did not reach the early stage, combination, full dose and full course of treatment, with a mean recurrence time of 8 months. In the telephone follow-up, the patient’s recovery proceeded well.Conclusion: The present study revealed that the recurrence in male gender, advanced age, smoking and irregular treatment is higher. On the contrast, early intervention, a combination of adequate course of anti-infection treatment and timely surgery can improve the prognosis.Keywords: Brucella, brucellosis-related aneurysm, clinical features, retrospective analysis, case series
