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Images in Thorax
Aortic rupture involving matrix metalloproteinases 8 and 9 during Staphylococcus aureus pneumonia
  1. Mitsuo Hashimoto1,
  2. Saki Kuriiwa1,
  3. Ayako Kojima1,
  4. Shunsuke Minagawa1,
  5. Takanori Numata1,
  6. Hiromichi Hara1,
  7. Jun Araya1,
  8. Yumi Kaneko1,
  9. Katsutoshi Nakayama1,
  10. Mamiko Owada2,
  11. Daisuke Aizawa2,
  12. Takashi Yorozu2,
  13. Masafumi Suzuki2,
  14. Kazuyoshi Kuwano1
  1. 1 Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  2. 2 Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Mitsuo Hashimoto, Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan; mitsuoha-georgetown{at}live.jp

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An 87-year-old man was admitted to Jikei University Hospital presenting with fever and fatigue. Physical examinations revealed inspiratory coarse crackles on the left lung field. A chest CT detected a tumour-like consolidation around the thoracic aorta (figure 1A). Biochemical examinations found a high number of white blood cells and elevated C-reactive protein level, and a diagnosis of pneumonia was made. Penicillin antibiotics (ampicillin/sulbactam) were administered. Two days later, methicillin-sensitive Staphylococcus aureus (MSSA) was detected in two sets of blood cultures. An echocardiogram showed no vegetation and a urine culture was negative. A sputum culture was unobtainable, but pneumonia was the only focus of infection for the MSSA. Penicillin antibiotics were continued, but the patient suddenly developed cardiopulmonary arrest …

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Footnotes

  • Contributors MH was responsible for the conception, design and drafting the work. JA, KN and KK were responsible for the final approval of the manuscript. All authors were involved in the multidisciplinary team consultation.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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