zithromax and Aortic-Aneurysm

Cardiovascular involvement in COVID-19 has different features. Here we report the ominous fate of a neglected adolescent with Williams syndrome that was infected by SARS-CoV-2 and ended by acute aortic dissection.

Topics: Adolescent; Anti-Bacterial Agents; Antiviral Agents; Aortic Aneurysm; Aortic Dissection; Aortic Stenosis, Supravalvular; Aortitis; Azithromycin; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Enzyme Inhibitors; Fatal Outcome; Glucocorticoids; Humans; Hydroxychloroquine; Immunoglobulins, Intravenous; Immunologic Factors; Lopinavir; Male; Methylprednisolone; Oseltamivir; Recurrence; Ritonavir; SARS-CoV-2; Systemic Inflammatory Response Syndrome; Williams Syndrome

A 39-year-old Philipino man presented with acute onset fever and headache. Neurological examination was normal except for neck stiffness. There was no history of chest pain, cough or breathlessness. Cerebrospinal fluid (CSF) showed a mild increase in protein with normal sugar and lymphocytic pleocytosis. CSF PCR for herpes simplex and varicella zoster virus was negative. He developed acute right haemiplegia a week after hospitalisation. MRI showed acute infarct in the left centrum semiovale. His angiogram showed aneurysm in the left subclavian artery and aortic arch. The mycoplasma antibody test came positive with very high titres, while rest of the workup was negative. He was treated with azithromycin and his symptoms improved completely.He was asymptomatic on follow-up after a month. His repeat immunoglobulin G mycoplasma antibody titre showed elevation. Mycoplasma infection is a treatable cause of meningoencephalitis and stroke secondary to vasculitis. Arterial aneurysms are known to occur with mycoplasma infection although rare.

Topics: Adult; Aneurysm; Anti-Bacterial Agents; Aortic Aneurysm; Azithromycin; Humans; Male; Meningoencephalitis; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Stroke; Subclavian Artery