A Fatal Case ofKlebsiella pneumoniaeMycotic Aneurysm

Chao, Chien‐Ming; Lee, Kun-Kuang; Wang, Chia-Sheng; Chen, Ping-Jen; Yeh, Tsung-Chih

doi:10.1155/2011/498545

Cited by 4 publications

(7 citation statements)

References 8 publications

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“…Mycotic or infectious causes are the most common aetiologies for the development of SMA aneurysms, with Streptococci being the most reported cause followed by Staphylococci [4]. Klebsiella, the organism grown in the blood culture of our patient, has been reported in literature as a much rarer cause [5,6]. K. pneumoniae is a gram negative, encapsulated, non-motile bacterium [7] normally found as a part of the normal flora of human intestinal tract, but it is also an opportunistic pathogen [8] causing pneumonia, bacteraemia, and intra-abdominal infections [6].…”

Section: Discussionmentioning

confidence: 62%

“…Klebsiella, the organism grown in the blood culture of our patient, has been reported in literature as a much rarer cause [5,6]. K. pneumoniae is a gram negative, encapsulated, non-motile bacterium [7] normally found as a part of the normal flora of human intestinal tract, but it is also an opportunistic pathogen [8] causing pneumonia, bacteraemia, and intra-abdominal infections [6]. Most cases of mycotic SMA aneurysms have diabetes mellitus as a risk factor [6]; however, our patient was not diabetic.…”

Section: Discussionmentioning

confidence: 62%

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by Klebsiella pneumoniae. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive K. pneumoniae and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 62%

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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“…K. pneumoniae is a normal flora of the human mouth and intestine. The various clinical manifestations of K. pneumoniae include pneumonia, intra-abdominal infection, bacteremia, and soft tissue infection[ 9 , 10 ]. However, pseudoa-neurysm caused by K. pneumoniae is rare.…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular treatment with long-term antibiotic therapy for infectious pseudoaneurysm due to Klebsiella pneumoniae: A case report

Wang

Zhao

Huang

et al. 2020

WJCC

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BACKGROUND Infectious common femoral artery pseudoaneurysm caused by Klebsiella pulmonary infection is a relatively infrequent entity but is potentially life and limb threatening. The management of infectious pseudoaneurysm remains controversial. CASE SUMMARY We reported a 79-year-old man with previous Klebsiella pneumoniae pulmonary infection and multiple comorbidities who presented with a progressive pulsate mass at the right groin and with right lower limb pain. Computed tomography angiography showed a 6 cm × 6 cm × 9 cm pseudoaneurysm of the right common femoral artery accompanied by occlusion of the right superficial femoral artery and deep femoral artery. He underwent endovascular treatment (EVT) with stent–graft, and etiology of infectious pseudoaneurysm was confirmed. Then, 3-mo antibiotic therapy was given. One-year follow-up showed the stent–graft was patent and complete removal of surrounding hematoma. CONCLUSION The femoral artery pseudoaneurysm can be caused by Klebsiella pneumoniae deriving from the pulmonary infection. Moreover, this unusual case highlights the use of EVT and prolonged antibiotic therapy for infectious pseudoaneurysm.

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“…They comprise only 0.7%–1.3% of all aortic aneurysms [ 1 ]. Klebsiella -associated infections are extremely rare [ 2 ]. The risk of mortality and morbidity in infectious aortic aneurysm is very high, with reported rates of 10%–36% and 60%–70%, respectively [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…K. pneumoniae is generally seen in patients with pneumonia, skin or soft tissue infection, or urinary tract infection. Klebsiella infection is strongly related to diabetic or immuno-suppressed patients [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Recurrent Aortic Rupture Associated with Klebsiella pneumoniaePericarditis Treated by Two Separate Aortic Operations

Han

Ryu

Seo

et al. 2016

Korean J Thorac Cardiovasc Surg

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A 49-year-old female presented with severe dyspnea. She was diagnosed with cardiac tamponade combined with ascending aortic pseudoaneurysm and rupture, which was caused by Klebsiella pneumoniae infection. This extremely rare condition was managed by an emergency pericardiostomy and two separate aortic operations. Antibiotics active for the K. pneumoniae isolate were used throughout. The patient was well for nine months after discharge and continues to be followed up for signs of possible reinfection.

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A Fatal Case ofKlebsiella pneumoniaeMycotic Aneurysm

Cited by 4 publications

References 8 publications

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

Successful endovascular treatment with long-term antibiotic therapy for infectious pseudoaneurysm due to Klebsiella pneumoniae: A case report

A Case of Recurrent Aortic Rupture Associated with Klebsiella pneumoniaePericarditis Treated by Two Separate Aortic Operations

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