A Fatal Infected Coronary Aneurysm due to Bacteremia Caused by a Foot Ulcer in a Diabetic Dialysis Patient

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  • Matoba Yuka
    Department of Metabolism and Endocrinology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
  • Okamoto Kanako
    Department of Metabolism and Endocrinology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
  • Sakaki Yuka
    Department of Metabolism and Endocrinology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
  • Saito Ryoko
    Department of Metabolism and Endocrinology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
  • Ogo Atsushi
    Department of Metabolism and Endocrinology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center

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Other Title
  • 糖尿病足潰瘍に起因した感染性冠動脈瘤により致死的経過をたどった透析下糖尿病の1例
  • 症例報告 糖尿病足潰瘍に起因した感染性冠動脈瘤により致死的経過をたどった透析下糖尿病の1例
  • ショウレイ ホウコク トウニョウビョウ ソク カイヨウ ニ キイン シタ カンセンセイカン ドウミャクリュウ ニ ヨリ チシテキ ケイカ オ タドッタ トウセキ カ トウニョウビョウ ノ 1レイ

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Abstract

Infected aneurysms in the coronary artery are rare. We herein report a case of a infected aneurysm due to bacteremia caused by a diabetic foot ulcer. A 75-year-old male with type 2 diabetes mellitus and stage 5 chronic kidney disease was admitted to our hospital with an intractable ulcer on his right foot. Cultures of his blood and the wound yielded Methicillin-resistant Staphylococcus aureus (MRSA). On the second day of admission, he had a high fever and developed shortness of breath. His foot ulcer showed improvement, and the presence of other infection foci, including endocarditis, was excluded. Computerized tomography revealed a 60 mm coronary aneurysm in the proximal right coronary artery. Because of the MRSA infection and his poor general condition, surgical excision was not indicated. His inflammatory state persisted despite the treatment with adapted antibiotics, and he died of sepsis on the 30th day. In the pathological study, the aneurysm was diagnosed as infected aneurysm caused by bacteremia.<br>

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