Multifocal intra-wall gas appearance of the aorta was the presage of an infectious aneurysm

Abstract

An 84-year-old man suffered from a fever had an increasing inflammatory response by blood tests, and finally positive result for serum procalcitonin level. Clostridium septicum was detected in the peripheral blood culture, and we diagnosed him with sepsis. Because of his complains of chest and back pain, we performed computed tomography (CT) scan to find the source of infection and found multiple foci of gas retention scattered in the intra-aortic wall (Panel A). Twelve days later, the CT image during the follow-up observation showed multiple aneurysms, which rapidly growing at the sites consistent with the gas appearance, such as the aortic arch, descending thoracic aorta, and...