Infected abdominal aortic aneurysm caused by Brucella abortus: A case report

Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp., and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thrombosis. We report a case of brucellosis presenting as bacteremia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen.

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“…25–32, 35–45,47,49,50,52,53,55,56,57,58 Sulfa drugs include co-trimoxazole, terfonyl, and sulfanilamide.…”

Section: Figurementioning

confidence: 99%

Brucella arteritis: clinical manifestations, treatment, and prognosis

Herrick

Lederman

Sullivan

et al. 2014

The Lancet Infectious Diseases

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“…It is a zoonotic intracellular Gram-negative coccobacillus which causes multisystemic Malta fever, undulant fever, respiratory infections, and septicemia, especially in immunocompromised patients. It is a very rare cause for primary mycotic aortic aneurysm, 3 5 6 although there are a few case reports of primary endocarditis, ensuing septicemia, and associated focal aneurysms 4 7 of the aorta or other arteries. The mode of spread is usually from infected cattle directly, or more commonly via milk and other body fluids.…”

Section: Discussionmentioning

confidence: 99%

Brucella-Induced Ruptured Infrarenal Dissecting Abdominal Aortic Aneurysm

Nair

Goura

Pitchai

et al. 2019

Aorta

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Mycotic aneurysms, often saccular, accounting for approximately 2.5% of all abdominal aortic aneurysms, possess increased risk of rupture, uncontrolled sepsis, and protracted hospital stay and are associated with high morbidity and mortality. The authors report the case of a 49-year-old female with no known comorbidities who presented with free rupture of an infrarenal dissecting mycotic aneurysm and underwent emergent open repair successfully. The etiological agent, Brucella melitensis, a Gram-negative zoonotic coccobacillus, is rarely reported to cause mycotic aneurysm.

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“…However, infection of the cardiovascular system by Brucella is uncommon, and it is even rarer that Brucella infection directly causes aortic aneurysm, which is usually secondary to endocarditis in clinic. In 2007, Park et al [ 9 ] reported the world's first Brucella -infected abdominal aortic aneurysm in South Korea.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of Brucella-infected abdominal aortic aneurysm

Zhang

Ji²,

Wang³

2017

Medicine

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Rationale:In very rare cases, a primary infected abdominal aortic aneurysm (IAAA) is caused by a species of Brucella. In this report, we report such a case that was successfully treated with a novel approach. To the best of our knowledge, this was the first case occurring in China, in which an infection of the abdominal aortic aneurysm was caused by a Brucella species.Patient concerns:The clinical findings included high fever, fatigue, and abdominal pain.Diagnoses:The diagnosis was confirmed by computed tomography angiography and by bacteriologic isolation from the patient's blood culture.Interventions:The patient was given endovascular aneurysm repair (EVAR) and Brucella-sensitive antibiotics for 6 weeks.Outcomes:During the 10-month follow-up, the patient's clinical course remained uneventful.Lessons:Our case study supports the premise that endovascular aneurysm repair is an appropriate alternative strategy to treat an infected abdominal aortic aneurysm. Compared with conventional surgical treatment, EVAR with long-term oral antibiotics is a simpler, less traumatic, and more efficient procedure. However, this needs to be further evaluated through long-term follow-up.

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Infected abdominal aortic aneurysm caused by Brucella abortus: A case report

Cited by 18 publications

References 8 publications

Brucella arteritis: clinical manifestations, treatment, and prognosis

Brucella arteritis: clinical manifestations, treatment, and prognosis

Brucella-Induced Ruptured Infrarenal Dissecting Abdominal Aortic Aneurysm

Endovascular treatment of Brucella-infected abdominal aortic aneurysm

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