RESUMEN
Infectious native aortic aneurysm (INAA) are rare but life-threatening infections. Early microbiological identification is crucial to initiate adequate therapy and decrease the peri-operative risk, but can be challenging when blood cultures remain negative. We describe two cases of pneumococcal INAA with negative blood cultures, diagnosed in the with the pneumococcal urinary antigen test.
Asunto(s)
Aneurisma de la Aorta , Enfermedades Transmisibles , Infecciones Neumocócicas , Humanos , Antibacterianos/uso terapéutico , Cultivo de Sangre , Streptococcus pneumoniae , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/microbiología , Infecciones Neumocócicas/cirugía , Aneurisma de la Aorta/tratamiento farmacológico , Enfermedades Transmisibles/tratamiento farmacológico , Antígenos Bacterianos/orinaRESUMEN
OBJECTIVE: We investigated the diagnostic value of inflammation limited to the adventitia (ILA), and isolated vasa vasorum or small-vessel vasculitis (VVV, SVV) in temporal artery biopsies (TAB) for giant cell arteritis (GCA). METHODS: Two pathologists reviewed consecutive first TAB. Using the clinical diagnoses as the gold standard, positive predictive values (PPV) were calculated. RESULTS: Among the 75 patients without classic TAB features of GCA, 8 had GCA diagnoses. The PPV of ILA, VVV, and SVV seen by either or both pathologists were 17%, 0%, and 7%, and 17%, 0%, and 10%, respectively. CONCLUSION: (Peri)adventitial infiltrates in TAB poorly predict GCA.
