Volume 2021, Issue 1 7093607
Case Report
Open Access

Eosinophilic Granulomatosis Polyangiitis (EGPA) Masquerading as a Mycotic Aneurysm of the Abdominal Aorta: Case Report and Review of Literature

Pooja Kumari

Pooja Kumari

Division of Rheumatology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA tennessee.edu

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Debendra Pattanaik

Corresponding Author

Debendra Pattanaik

Division of Rheumatology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA tennessee.edu

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Claire Williamson

Claire Williamson

Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA tennessee.edu

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First published: 13 September 2021
Citations: 1
Academic Editor: Gregory J. Tsay

Abstract

Introduction. Aortic involvement leading to aortitis in eosinophilic granulomatosis polyangiitis (EGPA) is infrequent, and only 2 cases have been reported so far in the literature. Even more so, aortic aneurysm, secondary to EGPA, has never been reported and remains a diagnostic and therapeutic challenge. Case Presentation. We present a 63-year-old Caucasian male patient with a prior diagnosis of EGPA presenting with abdominal pain, nausea, and loose stools to the emergency department. Physical examination showed periumbilical tenderness. He had no peripheral eosinophilia but had high C-reactive protein and procalcitonin levels. CT abdomen revealed a mycotic aneurysm involving the infrarenal abdominal aorta. The patient declined surgical repair initially and was treated with IV antibiotics only. Unfortunately, 24 hours later, the aneurysm ruptured, leading to emergent axillofemoral bypass surgery. Surgical biopsy showed aortitis, periaortitis, and active necrotizing vasculitis. Conclusion. Abdominal aneurysms should be considered a complication of EGPA, and earlier immunosuppressive therapy should be considered to prevent further complications.

Conflicts of Interest

The authors have no any conflicts of interest.

Data Availability

All the data were included in the manuscript.

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