Source of aortic rupture:
(1) aneurysm
(2) dissection
(3) penetrating atherosclerotic ulcer (PAU)
Clinical findings:
(1) history of recent or active infection
(2) persistent fevers
(3) elevated serum C-reactive protein (CRP)
(4) persistent leukocytosis
Organisms involved include:
(1) Staphylococcus aureus
(2) Salmonella species
(3) Clostridium species
(4) Enterococcus species
(5) Streptococcus species
(6) Treponema pallidum (syphilis)
Demonstration of infectious organism:
(1) blood culture
(2) post-mortem culture
(3) histologic exam around the site of rupture or penetration
Reasons for a false-negative culture:
(1) high levels of antibiotics
(2) failure to culture a focus of active infection
Differential diagnosis:
(1) aortitis associated with a rheumatic disease
(2) noninfectious aortic dissection or atherosclerotic aneurysm
