Percutaneous coronary intervention-associated Actinomyces oris

Saeed, Walaa; Adam, Mohammad; Abdallah, Tasneem; Omrani, Ali S.

doi:10.1016/j.idcr.2020.e00929

Cited by 3 publications

(4 citation statements)

References 41 publications

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Section: Discussionmentioning

confidence: 99%

“…Of the coronary artery infections reported in the literature, most occurred within 4 weeks of stent placement and present with chest pain, fever, elevated troponins, and ECG changes [ 1 , 3 , 4 ]. Risk factors for infection have been noted to include older age, difficult vascular access, extended duration of the procedure, and repeated catheterizations using the same vascular access site [ 3 , 5 ]. Although the pathophysiology is unknown, it is believed that stent infections—especially early stent infections—occur due to contamination or a distant source of infection at the time stent of insertion [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for infection have been noted to include older age, difficult vascular access, extended duration of the procedure, and repeated catheterizations using the same vascular access site [ 3 , 5 ]. Although the pathophysiology is unknown, it is believed that stent infections—especially early stent infections—occur due to contamination or a distant source of infection at the time stent of insertion [ 1 , 3 ]. Furthermore, it has been suggested that stents allow for bacterial colonization and that endothelialization of stents likely play an important role in the prevention of infection.…”

Section: Discussionmentioning

confidence: 99%

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Coronary Stent Abscess in the Setting of Arteriovenous Graft Infection following COVID-19: An Autopsy Case Report

Butler

Chellappan

Litovsky

et al. 2023

Case Reports in Pathology

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While rare, coronary stent infections present with significant mortality—with most infections and further complications occurring within months of percutaneous coronary intervention (PCI). Here, we discuss a post-COVID-19 patient who presented approximately one year after PCI for declotting of an arteriovenous graft (AVG). Upon admission, the patient was found to be bacteremic with multilobar pneumonia and an infection of the AVG. Empiric antibiotics were started, and blood cultures were subsequently positive for MRSA. Removal of the AVG was unsuccessful, and two days after admission, the patient passed. Autopsy revealed a perivascular abscess in the RCA near the origin of the stent with a ground section of the RCA with stent revealing abundant calcific atherosclerosis and marked necrosis of the artery wall. The cause of death was determined to be sepsis complicating coronary artery disease and chronic renal failure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Coronary Stent Abscess in the Setting of Arteriovenous Graft Infection following COVID-19: An Autopsy Case Report

Butler

Chellappan

Litovsky

et al. 2023

Case Reports in Pathology

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“…Two further cases of actinomycosis (identification of Actinomyces oris and israelii) associated with percutaneous coronary intervention (performed four months before) were retrieved from the literature search [22,23]. Because of the different anatomical setting and presentation, these two reports were not included in the list of PVGI cases caused by Actinomyces spp.…”

Section: Literature Reviewmentioning

confidence: 99%

Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature

Del Fabro,

Volpi,

Fumarola

et al. 2023

Microorganisms

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Background: Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of Actinomyces spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease. Methods: We conducted a retrospective case-series of Actinomyces-PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature. Results: We report five original cases of Actinomyces spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of A. odontolyticus involvement (3/13 cases were associated with. Salmonella spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available. Conclusions: This case-series aims to raise the diagnostic suspicion and to describe the current management of Actinomyces-PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.

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Coronary stent infection: a systematic review

Suryawan

Luke

Agustianto

et al. 2021

Coronary Artery Disease

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Coronary stent infection (CSI) is the rarest complication associated with the percutaneous coronary intervention, occurring in less than 0.1% of cases. So far, all reported instances are limited to case reports. CSI presents itself in various, often confusing, ways in clinical settings. Therefore, the current systematic review summarizes reports of CSI's clinical presentations, causative pathogens, diagnoses and treatments. This systematic review considered three online databases, using reference lists as an additional source. All case reports or case series with stent infection in the coronary artery were included -however, reviews or commentaries, articles not published in English, and articles mentioning a history of hemodialysis or any surgery were excluded. Thirtytwo studies on 34 CSI patients were included in the final qualitative analysis. CSI predominantly affected males of a wide range of ages. The most common symptoms were chest pain and fever with various onsets. Interestingly, CSI usually occurred during the first stent implantation. Cultures and coronary angiography were the most common methods used to diagnose CSI. Furthermore, drug-eluting stents had a higher risk of infection than bare-metal stents. Aneurysms were the most frequent abnormalities observed in infected stents. The bacteria that most often caused CSI were Staphylococcus aureus and Pseudomonas aeroginosa. More than 90% of the reports mentioned using various antibiotics, and 74% mentioned carrying out surgery. Finally, a mortality rate of 26.47% among CSI patients was calculated.

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Percutaneous coronary intervention-associated Actinomyces oris

Cited by 3 publications

References 41 publications

Coronary Stent Abscess in the Setting of Arteriovenous Graft Infection following COVID-19: An Autopsy Case Report

Coronary Stent Abscess in the Setting of Arteriovenous Graft Infection following COVID-19: An Autopsy Case Report

Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature

Coronary stent infection: a systematic review

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