Aortitis is typically a chronic, progressive disease manifestation associated 
with large vessel vasculitidies, most notably giant cell, Takayasu arteritis, 
and a newly described entity, isolated aortitis. The aortitis may lead to 
aneurysm formation and symptoms associated with branch vessel occlusion in these 
diseases, but aortic dissection is rare and usually a late complication of 
smoldering, incompletely treated disease. We present a case of aortitis in a 
previously healthy 39-year-old man who succumbed to aortic dissection hours 
after the onset of symptoms. No aneurysm or fibrosis was found on postmortem 
examination. The inflammation was characterized by disruption of the media with 
patchy transmural chronic and focally acute inflammatory infiltrate. We review 
case reports of other individuals with aortitis, who initially or very early in 
their course presented with aortic dissection in the absence of known rheumatic 
disease and most without evidence of aneurysm formation. We believe that this 
represents a process characterized by an aggressive vasculitis of the aorta with 
its own clinical features, a fulminant variety of isolated aortitis.