Patient: [Patient Name] MRN: [Medical Record Number] Date: [Date of Visit]
主诉 (zhǔ訴) Chief Complaint:
Document the patient’s main presenting concerns. These can vary depending on the location and severity of the infection but may include:
Fever (common)
Night sweats
Fatigue and malaise
Back pain (may be localized to the area of involvement)
Abdominal pain (if abdominal aorta involved)
Chest pain (if thoracic aorta involved)
Symptoms suggestive of end-organ dysfunction (e.g., neurological deficits if mycotic aneurysms are present)
现病史 (xiàn bìng shǐ) History of Present Illness:
Onset and duration of symptoms.
Progression of symptoms (worsening, stable).
Presence of any recent infections (skin infections, dental procedures, urinary tract infections) that could be a potential source.
Prior surgeries or procedures, particularly involving the aorta (increased risk).
Travel history (certain regions have higher prevalence of specific infectious agents).
既往史 (jì wàng shǐ) Past Medical History:
Underlying medical conditions that may increase risk (e.g., intravenous drug use, immunosuppression, prosthetic heart valves).
Prior history of vascular disease (atherosclerosis, peripheral artery disease).
Previous surgeries or infections.
家族史 (jiā zú shǐ) Family History:
Family history of aortitis (uncommon)
社会史 (shè huì shǐ) Social History:
Tobacco use (significant risk factor)
Intravenous drug use (high risk factor)
Occupation (increased risk for certain professions)
查体 (chá tǐ) Physical Examination:
Vital signs (often elevated temperature, tachycardia).
General examination: assess for signs of systemic inflammation (e.g., weight loss, fatigue).
Cardiovascular examination:
Listen for bruits over the aorta (abnormal sound due to turbulent blood flow).
Assess for signs of heart failure (if present).
Abdominal examination:
Palpate for abdominal aortic tenderness or pulsatile mass (if abdominal aorta involved).
Neurological examination (if end-organ dysfunction suspected).
辅助检查 (fú zhu zhuān chá) Laboratory Tests:
Complete blood count (CBC):
May show elevated white blood cells (leukocytosis) indicating infection.
Blood cultures: To identify the causative organism in the bloodstream.
Serologic tests:
May be helpful for specific infections (e.g., syphilis serology, HIV testing).
C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR):
Elevated levels suggest inflammation, but not specific for infectious aortitis.
Aortic imaging studies (essential for diagnosis):
CT angiogram with contrast: Most common imaging modality to visualize the aorta and identify aneurysms or abscesses.
MRI angiogram (may be used in some cases): Can provide additional information about soft tissue involvement.
PET scan (positron emission tomography): May be helpful in identifying areas of active inflammation.
组织活检 (zǔ zhī huó jiǎn) Tissue Biopsy:
Obtaining tissue samples from the infected aorta is ideal for definitive diagnosis but can be high-risk.
Biopsy may be performed during open surgery or using endovascular techniques.
Microscopic examination of the tissue can confirm the presence of infectious organisms.
诊断 (zhěn duàn) Diagnosis:
Infectious aortitis.
Specify the location of the involved aorta (e.g., thoracic aortitis, abdominal aortitis).
If possible, identify the causative organism (e.g., Salmonella aortitis, Staphylococcus aureus aortitis).
分期 (fēn qī) Staging (optional):
Some classification systems categorize infectious aortitis based on the severity of aortic involvement.
治疗方案 (zhì liáo fāng àn) Treatment Plan:
Infectious aortitis is a medical emergency requiring prompt treatment.
The mainstay of treatment is prolonged intravenous antibiotic therapy based on culture results or empiric broad-spectrum antibiotics.
Surgical intervention may be necessary in some cases, such as:
Rupture or imminent rupture of an infected aneurysm
Extensive aortic involvement with complications (e.g., mycotic