Acute aortic dissection in sepsis with Staphylococcus bacteraemia

• Published in: BMJ case reports Vol. 14; no. 7; p. e242293
• Main Authors: Rehan, Saad, Ha, Francis, Uddin, A K M Nizam
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 12-07-2021; BMJ Publishing Group
• Subjects: Abdomen; Aortic dissection; Aortic Dissection - complications; Aortic Dissection - diagnostic imaging; Atherosclerosis; Back pain; Bacteremia - complications; Bacteremia - drug therapy; Case reports; Coronary vessels; Humans; Hypertension; Images In; Sepsis; Sepsis - complications; Shear stress; Staphylococcal Infections - complications; Staphylococcal Infections - drug therapy; Staphylococcus; medical education; cardiovascular medicine; infectious diseases
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-242293

On examination, her blood pressure was 130/60 mm Hg and heart rate 80 bpm. Sepsis reduces vessel wall shear stress leading to microcirculatory dysfunction, loss of anticoagulation and increased local blood viscosity.2 Additionally, sepsis has been shown to increase inflammatory cytokine expression localised to the aortic lumen of mice even during its early presentation (measured at 72 hours and 120 hours) with resultant increased atheroma at 5 months follow-up.3 Existing atheroma (due to atherosclerosis) through intimal injury can become nidus for infection in sepsis and predisposes to aortitis. Contributors SR is the main author of this case study and FH also contributed to finalising the case and as a senior physician AKMNU supervised the whole process and did all relevant corrections as necessary for this case study.