1921 American Journal of Diseases of Children  
Aneurysm of the thoracic aorta is a rare condition in children. I have been able to collect and review thirty-one cases from the literature, besides the two cases which I have to report. ETICLOGY There is a great diversity of opinion on this subject, mainly because the real causative factors have not been worked out in many cases. Some authors believe that syphilis is practically always the prime factor in children as in adults, but a careful study of the available cases does not confirm this
more » ... ew. Bronson 1 has grouped these cases according to the etiologic factors into: (1) those aneurysms due to atheromatous degeneration; (2) those resulting from trauma (rare); (3) those due to erosion of the aorta from without; (4) a few following congenital malformations, and (5) last, but probably the most important factor in childhood, aortic aneurysms following in the wake of acute infectious diseases. Osler remarks that in adults the specific fevers commonly cause areas of degeneration in the intima of the aorta and occasionally in the media. Klotz 2 has shown that in childhood the aorta may be attacked during an acute infectious disease, especially those due to the streptococci. He claims that the organisms gain entrance to the aortic wall through the vaso vasoriim and lodge in the media, causing degen¬ erative changes which lead to a gradual weakening of the wall, with resulting dilatation, fibrosis and possibly aneurysm. A summary follows of the cases in which the apparent determining cause was an acute infectious aortitis. CASES DUE TO ACUTE INFECTIOUS AORTITIS Cask 1.-A definite history of five severe attacks of chorea was given. During the third attack the heart was involved. This attack was followed by diphtheria. During the fifth attack the aneurysm was diagnosed, five years
doi:10.1001/archpedi.1921.01910340014002 fatcat:6lzczzc7zvgxdofnypwzx2xnfu