Infectious Aortitis Following Type B Dissection.

backgroundInfectious aortitis of the native thoracic aorta is rare and life threatening, typically presenting with nonspecific symptoms. Diagnosis relies on advanced imaging and microbiological confirmation. Management involves targeted antibiotics with surgical intervention. CASE SUMMARY: We report a patient with Loeys-Dietz syndrome and a Stanford type B aortic dissection who developed Staphylococcus aureus bacteremia from a peripheral intravenous line. Despite targeted antibiotics, an infection involving the dissected thoracic aorta developed without involvement of an abdominal endograft placed 5 years earlier. As the patient's condition deteriorated, open surgical replacement was performed. Cultures confirmed Saureus infiltration. Postoperatively, pulmonary complications occurred, but the patient ultimately recovered after 12 weeks of intravenous and 12 weeks of oral antibiotics. DISCUSSION: This case illustrates bacteremic seeding of a dissected aorta and highlights the role of surgical debridement combined with targeted antibiotic therapy. TAKE-HOME MESSAGES: Saureus bacteremia can seed the native thoracic aorta, leading to life-threatening infectious aortitis. This condition can be successfully managed with open surgical repair and targeted antibiotic therapy.