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Background <p>Brucellosis can affect multiple systems throughout the body, with cardiovascular involvement being extremely rare. This patient initially presented with dysphagia, lacking typical symptoms such as “undulant fever”, lymphadenopathy, or joint and muscle pain. The final diagnosis was a Brucella-infected pseudoaneurysm of the thoracic aorta, which, to our knowledge, is the first reported case of its kind.</p> Case presentation <p>A 66-year-old Chinese male patient with no history of thoracic aortic surgery and no history of blunt chest trauma, was admitted to the hospital because of dysphagia more than 10 days. Gastroscopy revealed a raised lesion measuring approximately 2 × 2&#xa0;cm in size 32–34&#xa0;cm from the incisors, with a normal mucosal surface. The patient had elevated white blood cell count and CRP levels. Endoscopic ultrasound revealed a heterogeneous echoic mass, and pathological examination of the puncture sample revealed abundant neutrophils. Contrast-enhanced chest CT indicated a pseudoaneurysm of the thoracic aorta. The results of both the Rose Bengal plate test and the tube agglutination test were both positive, confirming that the thoracic aortic pseudoaneurysm was caused by Brucella infection, which compressed the esophagus. The patient was treated with antibiotics, and thoracic aortic endovascular stent graft placem ent was planned after infection control. However, one month later, the patient developed hematemesis, and surgical intervention was urgently recommended. The family refused further treatment, and the patient was discharged. Approximately two weeks after discharge, the patient passed away at home.</p> Conclusion <p>Brucella infection involving the cardiovascular system can lead to the extremely rare complication of a thoracic aortic pseudoaneurysm. This condition is associated with a high risk of rupture and life-threatening hemorrhage, resulting in an extremely poor prognosis. In patients who present with an infectious pseudoaneurysm, Brucella infection should be considered in the differential diagnosis to reduce the risks of misdiagnosis and missed diagnosis.</p>

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Thoracic aortic pseudoaneurysm with esophageal compression due to brucellosis: a rare case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Pei Gu,
  • Meina Lang,
  • Rongxia Sang,
  • Shumei Zhang,
  • Run Liu,
  • Nan Liu,
  • Xin Zhao,
  • Zhengrong Guo,
  • Yulan Liu

摘要

Background

Brucellosis can affect multiple systems throughout the body, with cardiovascular involvement being extremely rare. This patient initially presented with dysphagia, lacking typical symptoms such as “undulant fever”, lymphadenopathy, or joint and muscle pain. The final diagnosis was a Brucella-infected pseudoaneurysm of the thoracic aorta, which, to our knowledge, is the first reported case of its kind.

Case presentation

A 66-year-old Chinese male patient with no history of thoracic aortic surgery and no history of blunt chest trauma, was admitted to the hospital because of dysphagia more than 10 days. Gastroscopy revealed a raised lesion measuring approximately 2 × 2 cm in size 32–34 cm from the incisors, with a normal mucosal surface. The patient had elevated white blood cell count and CRP levels. Endoscopic ultrasound revealed a heterogeneous echoic mass, and pathological examination of the puncture sample revealed abundant neutrophils. Contrast-enhanced chest CT indicated a pseudoaneurysm of the thoracic aorta. The results of both the Rose Bengal plate test and the tube agglutination test were both positive, confirming that the thoracic aortic pseudoaneurysm was caused by Brucella infection, which compressed the esophagus. The patient was treated with antibiotics, and thoracic aortic endovascular stent graft placem ent was planned after infection control. However, one month later, the patient developed hematemesis, and surgical intervention was urgently recommended. The family refused further treatment, and the patient was discharged. Approximately two weeks after discharge, the patient passed away at home.

Conclusion

Brucella infection involving the cardiovascular system can lead to the extremely rare complication of a thoracic aortic pseudoaneurysm. This condition is associated with a high risk of rupture and life-threatening hemorrhage, resulting in an extremely poor prognosis. In patients who present with an infectious pseudoaneurysm, Brucella infection should be considered in the differential diagnosis to reduce the risks of misdiagnosis and missed diagnosis.