Coronary Stent Abscess in the Setting of Arteriovenous Graft Infection following COVID-19: An Autopsy Case Report.

IF 0.7 Q4 PATHOLOGY Case Reports in Pathology Pub Date : 2023-01-01 DOI:10.1155/2023/9998749
Jean Thompson Butler, Rajeshwari Chellappan, Silvio Litovsky, Sixto M Leal, Paul V Benson
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Abstract

While rare, coronary stent infections present with significant mortality-with most infections and further complications occurring within months of percutaneous coronary intervention (PCI). Here, we discuss a post-COVID-19 patient who presented approximately one year after PCI for declotting of an arteriovenous graft (AVG). Upon admission, the patient was found to be bacteremic with multilobar pneumonia and an infection of the AVG. Empiric antibiotics were started, and blood cultures were subsequently positive for MRSA. Removal of the AVG was unsuccessful, and two days after admission, the patient passed. Autopsy revealed a perivascular abscess in the RCA near the origin of the stent with a ground section of the RCA with stent revealing abundant calcific atherosclerosis and marked necrosis of the artery wall. The cause of death was determined to be sepsis complicating coronary artery disease and chronic renal failure.

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冠状动脉内支架脓肿在COVID-19后动静脉移植物感染:尸检病例报告。
虽然罕见,但冠状动脉支架感染的死亡率很高,大多数感染和进一步的并发症发生在经皮冠状动脉介入治疗(PCI)的几个月内。在这里,我们讨论了一位covid -19后患者,他在PCI后大约一年出现了动静脉移植物(AVG)的脱血。入院时,患者被发现是多叶性肺炎和AVG感染的菌血症,开始使用经验性抗生素,随后血培养为MRSA阳性。AVG移除不成功,入院两天后,患者出院。尸检显示在支架起源附近的RCA血管周围脓肿,RCA的地面切片显示大量钙化动脉粥样硬化和明显的动脉壁坏死。死亡原因确定为败血症合并冠状动脉疾病和慢性肾功能衰竭。
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