Background Determining the aetiology of aortitis is often challenging, in particular to distinguish infectious aortitis (IA) and non-infectious aortitis (NIA). This study aims to describe and compare the clinical, biological and radiological characteristics of IA and NIA and their outcomes. Methods A multicentre retrospective study was performed in 10 French centres, including patients with aortitis between January 1st, 2014 and December 31st, 2019. Results One hundred and eighty three patients were included. Of these, 66 had an IA (36.1%); the causative organism being Enterobacterales and streptococci in 18.2%, Staphylococcus aureus in 13.6% and Coxiella burnetii in 10.6%. NIA was diagnosed in 117 patients (63.9%), mainly due to vasculitides (49.6%), followed by idiopathic aortitis (39.3%). IA was more frequently associated with aortic aneurysms (78.8% vs 17.6%, p < 0.001), especially located in the abdominal aorta (69.7%vs 23.1%, p < 0.001). Crude and adjusted survival were significantly lower in IA compared to NIA group (p < 0.001 and p = 0.006, respectively). In the IA cohort, high ASA score (Hazard ratio [HR] = 2.47, 95% confidence interval [95%CI], 1.08-5.66, p = 0.033) and free aneurysm rupture (HR = 9.54, 95%CI [1.04-87.11], p = 0.046) were significantly associated with mortality after adjusting for age, sex, and Charlson’s comorbidity score. Effective empiric antimicrobial therapy, initiated before any microbial documentation, was associated with a decreased mortality (HR = 0.23, 95%CI [0.08, 0.71], p = 0.01). Conclusion IA was complicated by significantly higher mortality rates compared with NIA. An appropriate initial antibiotic therapy appeared as a protective factor in IA.

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Drug addiction is a major social and medical concern. Infected groin pseudoaneurysm (IGP) is the result of direct arterial needlestick injury associated with contamination of the arterial wall or peri-arterial area by the injection equipment. Femoral artery (FA) ligation with extensive debridement is an alternative to direct revascularization in an area of sepsis. In case of femoral bifurcation free of infection or in case of isolated FA below the femoral artery of thigh involvement, a simple ligation of the FA is performed. Ligation of each femoral vessel is indicated in case of extension of the infection to the femoral bifurcation. Proximal ligation is performed on the proximal part of the FA. Distal ligation is performed on the proximal part of the deep artery of thigh and the FA below the origin of the deep artery of thigh. Ligation is effective and represents an appropriate method to control hemorrhage and sepsis syndrome in IGP.