Analysis on a case of brucellosis with left common iliac artery dissection and pseudoaneurysm
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摘要: 布鲁氏菌病（布病）是最常见的人畜共患传染病。 心血管受累少见，却是布病主要的死亡原因，最常见的是感染性心内膜炎，而感染性动脉瘤非常罕见。 本研究通过1例布病伴左侧髂总动脉夹层并假性动脉瘤患者的临床症状和体征、影像学改变、实验室多项检查的异常情况，总结临床治疗经验。 患者影像学检查显示，腹部病变部位动脉血管见囊状突起，动脉壁见钙化影。 经布鲁氏菌血清学检查，确诊为布病伴左侧髂总动脉夹层并假性动脉瘤。 经规范的抗感染治疗后全身炎症得以控制，出院后复查假性动脉瘤缩小治愈。 通过本病例加强临床医师对于布病感染性动脉瘤的认识，减少漏诊、误诊。Abstract: Brucellosis is the most common zoonotic infectious disease. Though rare, cardiovascular involvement is the main cause of death for brucellosis. Infectious endocarditis is most common, but infectious aneurysm is very rare. This article summarizes the clinical treatment of a case of brucellosis with left common iliac artery dissection and pseudoaneurysm based on the analysis on the clinical symptoms and signs, imaging changes, and laboratory test abnormalities. The imaging examination showed that there were saccular processes in the arteries of the abdominal lesion and calcified shadows in the arterial wall. Brucella serological examination confirmed brucellosis with left common iliac artery dissection and pseudoaneurysm. After the standard anti-infection treatment, the systemic inflammation was controlled. After discharge, the clinical symptoms and signs of brucellosis disappeared, and the color ultrasound showed that the pseudoaneurysm was reduced and cured. It is necessary to improve clinicians' understanding of brucellosis infectious aneurysm to reducee missed diagnosis and misdiagnosis.
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Key words:
- Brucellosis /
- Infectious aneurysm /
- Diagnosis /
- Treatment
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图 2 2021年12月17日患者腹主动脉CT（左）与CTA（右）图
Figure 2. CT (left) and CTA (right) of aorta abdominalis, December 17, 2021
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