Infective Abdominal Aortic Aneurysm due to Haemophilus Influenza Identified via the Polymerase Chain Reaction

Whitfield, C.; Lonsdale, R. J.; Rahbour, G.; Parsons, Helena; Dodd, P.D.F.

doi:10.1016/j.ejvs.2008.01.020

Cited by 11 publications

(9 citation statements)

References 4 publications

(1 reference statement)

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“…5,6 Generally, Salmonella and staphylococcal species are the most common agent for infective aneurysm. [5][6][7] In this case, against expectation, H. influenzae was detected. H. influenzae is a rarely reported causative agent, with a limited number of isolated case report.…”

Section: The Contiguous Direct Spread Of Infection To the Arterialmentioning

confidence: 77%

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Sato

Kobayashi

2012

Int J Angiol

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Infective or mycotic aneurysm is rare but a life-threatening disease. To our knowledge, the incidence of this disease is 0.65 to 2% of all aortic aneurysms. [1][2][3] This disease has an increased tendency to grow rapidly and to rupture. Patients with this disease have severe comorbidities and coexisting sepsis. Conventional surgical treatment, which consists of a radical operation with resection of the aneurysm, extensive local debridement, and revascularization by in situ reconstruction or extra-anatomic bypass is the gold standard but carries a high mortality. Recently, some authors have described that endovascular aneurysm repair (EVAR) for infective abdominal aortic aneurysm (IAAA) was effective in perioperative and mid-term results. 3,4 Salmonella and staphylococcal species are predominant in the cause of IAAA, however, in this case, we detected Haemophilus influenzae. We reported this very rare case with the review of the English literature. Case ReportA 69-year-old man had fever (over 39°C) and, 10 days later, he had severe abdominal and back pain. He consulted nearby doctor and was introduced to our hospital. At the time of initial examination, he did not have fever (36.7°C). On the physical examination, he complained of the spontaneous pain and tenderness at lower abdomen. In laboratory evaluation, white blood cell count and C-reactive protein (CRP) level were elevated, 9700/μL and 12.87 mg/dL, respectively. Furthermore, the level of glycated hemoglobin was 6.2% and he had mild diabetes mellitus. Blood culture result was negative.Abdominal-enhanced computed tomography (CT) scan demonstrated a 35-mm saccular aneurysm of the infrarenal aorta surrounded by inflammatory findings (►Fig. 1A-C). He was diagnosed as having IAAA. First, we treated him with intravenous antibiotic administration for a week. The antibiotic was cefazolin sodium (2 g/day) to cover staphylococcal and Salmonella species. Just before operation, the value of white blood cell count and CRP had decreased down to 6200/μL and 2.54 mg/dL, respectively. We thought that preoperative antibiotic therapy was effective. We performed operation on day 8 after antibiotic administration, and resected the saccular aneurysm with extensive local debridements and irrigation. Revascularization was made in situ reconstruction with expanded polytetrafluoroethylene graft, and entire AbstractInfective abdominal aortic aneurysm (IAAA) is relatively rare, but a case which is caused by Haemophilus influenzae type B is very rare. We experienced one IAAA case due to H. influenzae type B. The patient was 69-year-old man presenting with severe abdominal and back pain and elevated C-reactive protein (CRP), as inflammatory marker. The patient was found to have saccular aneurysm infrarenal aorta on computed tomography scanning. First, we started to treat him with antibiotic agent and second, we operated him at day 8 after admission with expanded polytetrafluoroethylene graft. Revascularization was made in situ reconstruction. As the result of culture with aneurysm wall,...

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Section: The Contiguous Direct Spread Of Infection To the Arterialmentioning

confidence: 77%

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Sato

Kobayashi

2012

Int J Angiol

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“…The most common organisms identified in mycotic aneurysms are Salmonella spp., Mycobacterium tuberculosis , gram‐positive cocci, and gram‐negative bacilli, excluding Salmonella. 2 H. influenzae is a rarely reported causative agent, with a limited number of isolated case reports 3‐5 . All reported cases have been limited to the abdominal aorta and the cause of infection was associated with upper respiratory tract infection, cellulitis, or gastroenteritis.…”

Section: Discussionmentioning

confidence: 99%

“…If there is active infection, resection of the aorta and extra‐anatomic bypass or homograft replacement is the appropriate procedure. In all reported cases involving H. influenzae , in situ reconstruction with a prosthetic graft or autogenous vein graft was used, without the use of omental or muscle flaps 3‐5 . Müller et al demonstrated that in situ reconstruction with a prosthetic graft and rigorous debridement of all infected tissue was necessary and an omental pedicle was used when technically possible 6 …”

Section: Discussionmentioning

confidence: 99%

Mycotic Aneurysm of the Descending Thoracic Aorta Caused byHaemophilus Influenzae

Tsutsumi

Monta

Kohshi

et al. 2010

Journal of Cardiac Surgery

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A 59-year-old man presented with a three-month history of back pain, and enhanced computed tomography demonstrated an acutely expanding aneurysm of the descending thoracic aorta with slight erosion of the corresponding vertebrae. Because of suspected infectious or inflammatory etiology, he was managed with a combination of emergency aortic repair using prosthetic graft with omental flap and antibiotic chemotherapy. Haemophilus influenzae was identified from perioperative specimens and the postoperative course was uneventful.

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“…Other organisms occasionally isolated from mycotic aneurysms include Streptococcus species and Enterococcus species, Mycobacterium tuberculosis, Clostridium species (Moneta et al, 1998) and some Gram-negative bacilli. H. influenzae has been rarely implicated in this infection, with only a handful of case reports in recent years (Moneta et al, 1998;Whitfield et al, 2008), and only one other case involving H. influenzae type f (Adlakha et al, 1994) to our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm of the abdominal aorta caused by Haemophilus influenzae type f

Suarez

Glover

Cowan

et al. 2013

Journal of Medical Microbiology

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Infective Abdominal Aortic Aneurysm due to Haemophilus Influenza Identified via the Polymerase Chain Reaction

Cited by 11 publications

References 4 publications

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Mycotic Aneurysm of the Descending Thoracic Aorta Caused byHaemophilus Influenzae

Mycotic aneurysm of the abdominal aorta caused by Haemophilus influenzae type f

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