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혈액투석 환자에서 Staphylococcus aureus 감염에 의한 감염성 복부 대동맥류 파열
문동규 ( Dong Gyu Moon ),박성민 ( Sung Min Park ),문설경 ( Sul Kyung Moon ),심병주 ( Byung Joo Shim ),신석준 ( Seok Joon Shin ),송호철 ( Ho Cheol Song ),최의진 ( Eui Jin Choi ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.1
Infectious aneurysms in hemodialysis patients are very rare. It is assumed that injuries on atherosclerotic vessel walls are involved in the development of aneurysms associated with septicemia. Rupture of infectious aneurysms carries a high mortality rate because it often leads to hemorrhagic shock. Here we report the case of a hemodialysis patient with rupture of an abdominal aortic infectious aneurysm secondary to Staphylococcus aureus septicemia. A 72 year-old male hemodialysis patient presented with diarrhea and fever. Staphylococcus aureus was identified in his blood culture. On the sixth day after admission, he developed sudden abdominal pain, distension and hypotension, so we assumed hypovolemic shock due to intraabdominal hemorrhage. On abdominal CT, he was found to have a ruptured, 2.4×2 cm infrarenal abdominal aortic aneurysm with a large amount of retroperitoneal hemorrhage. His final diagnosis was rupture of an infectious aneurysm based on the presence of Staphylococcal bacteremia. He underwent a percutaneous stent graft in the infrarenal aorta successfully. However, two weeks later, he developed septic shock due to a newly developed intestinal perforation and died of multiorgan failure.