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

Abstract

Xin-Qi He,1,* Hui-Qing Qiu,2,* Meng Wang,3,* Ya-Fei Mao,4 Xin-Yuan Li,4 Xian-Yun Wang,5 Yu-Lan Geng,4 Le Wang6 1Department of Vascular Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 3Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 4Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 5Scientific Research Data Center, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 6Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yu-Lan Geng, Department of Laboratory Medicine, The First Hospital of Hebei Medical University, No. 89 of Donggang Road, Yuhua District, Shijiazhuang, 050031, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected] Le Wang, Department of Cardiology, The First Hospital of Hebei Medical University, No. 89 of Donggang Road, Yuhua District, Shijiazhuang, 050031, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]: 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

Keywords

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