Nonspecific infectious aortitis is caused by various bacteria that enter the aortic wall from the blood during bacteremia, such as sepsis or drug addicts, or directly from foci of infection in nearby organs and tissues, mainly the mediastinum and lungs. More Info /

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The development of infectious inflammation of the aorta is promoted by damage to its endothelium in the area of ​​the aneurysm or (in its absence) atherosclerosis. The most common pathogens that cause infectious aortitis are Staphylococcus aureus and Salmonella. The latter accounts for about 50% of Cefuroxime of this disease (J. Ewart et al., 1983), which is explained by its ability to penetrate intact endothelium. Infectious inflammation begins in the vasa vasorum and spreads to all membranes of the aorta.

Nonspecific aortoarteritis, or Takayasu's disease, is a nonspecific non-infectious inflammatory disease of the aorta and its large branches, primarily the arch, with the development of stenosis of their lumen. The disease is named after a Japanese ophthalmologist who first described multiple arteriovenous anastomoses around the optic disc associated with cataract in a young woman. Later it turned out that such sexual dimorphism is very characteristic.

The clinic is nonspecific and is determined by the development of an aneurysm, its rupture, and fever of unknown origin. Due to the relatively rapid progressive thinning of Ceftin wall, rupture is inevitable, even with antibiotic therapy, and only surgical excision of the aneurysm with graft plasty can prevent it.

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The disease is especially common in Asia, but also occurs in all other countries of the world. Its etiology is unknown, the pathogenesis is presumably autoimmune. An important role is played by hereditary predisposition. The most characteristic is the lesion of the aorta, more often the arch and branches extending from it in the region of their mouths (the so-called type I nonspecific aortoarteritis).

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Often, however, other sections of the aorta are also involved in the inflammatory process - the ascending and descending thoracic and abdominal parts and the renal, mesenteric and iliac arteries extending from the abdominal aorta. The defeat of the thoraco-abdominal part of the aorta and its branches is classified as type II Takayasu's disease, and at the same time the aortic arch and its thoraco-abdominal part - to type III. There is also a much more rare type IV, which is characterized by involvement of the pulmonary artery in the process.

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Morphological examination at an early stage of the disease reveals panarteritis, which begins with inflammation of the adventitial membrane and is accompanied by degenerative changes in myocytes and elastic fibers of the middle membrane. Subsequently, fibrotic changes with intimal proliferation come to the fore, which, together with the organization of parietal thrombi, leads to wall thickening and narrowing of the lumen of the vessel sections. Aneurysm formation is rare.
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The disease in most cases begins at the age of 15-30 years with the appearance of nonspecific general symptoms - fever, weakness, malaise, weight loss, arthralgia. In a laboratory study, an increase in ESR, anemia, and dysproteinemia are noted. During this period, the cause of the disease, as a rule, remains unrecognized, and the diagnosis is made much later after the onset of symptoms and signs of stenosis of the branches of the aortic arch with the development of ischemia of the corresponding organs.
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One of the most common signs is a weakening of the pulse in one or both radial arteries, up to its complete disappearance, in connection with which Takayasu's disease has received another figurative name - the disease of the absence of a pulse.
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Patients are also often concerned about various manifestations of circulatory disorders in the extracranial arteries in the form of transient ischemic attacks, ischemic stroke, visual impairment, up to blindness. Narrowing of Ceftin part of the aorta proximal to the renal arteries or stenosis of their mouths cause the development of secondary arterial hypertension, which occurs in more than 50% of patients. Its identification is sometimes difficult due to the weakening of the pulse in the upper extremities.
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