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A Woman in Her 60s With an Unusual Recurrent High Fever and Chills
JAMA Cardiology  (IF14.676),  Pub Date : 2021-11-01, DOI: 10.1001/jamacardio.2021.3362
Jiehua Li, Hao He, Chang Shu

What is the reason for recurrent fever in a patient with a history of thoracic endovascular aortic repair? A woman in her 60s presented with recurrent high fever (>39 °C) and chills for 1 year. She had undergone thoracic endovascular aortic repair for acute type B aortic dissection 9 years ago. Blood cultures returned positive results for Eikenella corrodens. A whole-body scan with [18F]fluoro-2-deoxy-D-glucose positron emission tomography–computed tomography (18F-FDG PET–CT) showed abnormal 18F-FDG accumulation alongside the aortic stent graft, with a maximum standard uptake value of 12.18 (Figure). The patient took intravenous and then oral linezolid for 2 months and then underwent a thoracotomy and replacement of the descending aorta. A culture of resected stent graft confirmed the infection. She recovered well and lived uneventfully after the operation. Aortic graft infection is an unusual, challenging complication of thoracic endovascular aortic repair.1 The 18F-FDG PET–CT has emerged as a useful diagnostic modality.2,3 Wide debridement, graft replacement, and antibiotic use are essential for aortic graft infection treatment.4,5