Q fever aortic infection causing an aortoduodenal fistula after endovascular aneurysm repair

Abstract

An aortoduodenal fistula is a rare complication of endovascular aortic aneurysm repair. Q fever infection is known for its vascular tropism, and arterial fistulas have been reported in association with Coxiella burnetii infections. We report the case of a 78-year-old patient who had developed an aortoduodenal fistula secondary to vascular Q fever 5 years after he had been treated with an aortic endograft. Explantation of the endograft, autogenous reconstruction using the neo-aortoiliac system procedure, and duodenal repair were performed as a curative surgical treatment of this serious vascular condition. At the 9-month follow-up examination, the patient showed no signs of recurrent vascular infection and was instructed to complete an 18-month antibiotic regimen.

Massive gastrointestinal bleed due to a primary aortoenteric fistula

“…Risk factors for the development of a primary AEF include smoking, pre-existing aneurysmal disease and mycotic aneurysm. Q-fever is known to have several acute and chronic cardiovascular sequelae including infected (mycotic) aortic aneurysms, as well as infective endocarditis and infected vascular prostheses 4–7…”