主动脉夹层误诊为带状疱疹1例并文献复习

A Case of Aortic Dissection Misdiagnosed as Herpes Zoster and Review of the Literature

患者男,76岁。背部散在皮疹伴疼痛2d,高血压病病史8年。皮肤科情况:躯干部散在粟粒至绿豆大小淡红色扁平丘疹,右背部为著,部分皮疹融合。疑诊为带状疱疹,予抗病毒治疗后疼痛不见缓解。CT检查示:大动脉管壁及冠状动脉走行区见钙化影;胸主动脉降支增宽,管壁环状增厚,密度增高,钙化内膜片向内移位。诊断:主动脉夹层。

A 76-year-old male presented with scattered rash on his back with pain for 2 days. He had a hypertensive history for 8 years. Dermatological examination revealed of miliary to mung bean size pale red flat papules on trunk, which was marked on right back, partially merged. The patient was suspected as herpes zoster. Antiviral therapy did not relieve the pain. CT examination showed calcification shadow zone of large artery wall and coronary artery. Branches of descending thoracic aorta widened, tube wall annular thickening, density increased, inward displacement of intimal flap with calcification. Diagnosis was aortic dissection.