Large Vessel Giant Cell Arteritis as an Initial Manifestation of Infected Abdominal Aortic Aneurysm

Abstract

We present a case of large vessel giant cell arteritis as an initial manifestation of an inflammatory abdominal aortic aneurysm. An 84-year-old woman, who had a persistent fever for one month, was transferred to our care. A computed tomography scan revealed a saccular abdominal aortic aneurysm with inflammation. A clinical diagnosis of inflammatory abdominal aortic aneurysm was established. Antibiotics were unable to control the fever and inflammatory reaction, so an abdominal aortic vascular prosthesis replacement was performed. Ten days after surgery, an active fever and inflammatory reaction recurred. Pathological examination of the aneurysm wall revealed giant cells in aortic intima. A postoperative diagnosis of large vessel giant cell arteritis was established. The fever and inflammatory reaction promptly improved with the administration of steroids. Large vessel giant cell arteritis diagnosed by pathological examination is rare, yet it is important to suspect giant cell arteritis in this situation.