Succesful Endovascular Repair of an Abdominal Mycotic Aneurysm. A Case Report

Abstract

A 73-year-old man was admitted to the emergency department presenting with cramping pain in the left iliac fossa that had persisted for ten days, with diarrhoea and dysuria. A recent onset of high fever had urged him to the hospital. A routine blood sample showed a leukocytosis of 11.9 x 10(3)/mm(3) and an elevated CRP of 16 mg/dl. Haemocultures and a urine sample were taken. A colonoscopy and ultrasound showed no abnormalities. The urine culture contained salmonella enteritidis. On day 5 a CT scan of the abdomen was performed. This showed a saccular aneurysm of the abdominal aorta, approximately 2 cm in length, with clear signs of a contained rupture. An urgent EVAR procedure was performed. An Excluder bifurcation-endoprosthesis was placed under antibiotic coverage. Control CT scan showed a thrombosis of the aneurysm and a type II endoleakage. The endoleakage spontaneously resolved within 3 months. The patient was kept on antibiotics (levofloxacine) for 4 months. We suggest that the use of an endoprosthesis could be a good and safe alternative for the repair of infrarenal mycotic aorta aneurysm.

A Novel Treatment Strategy for Infected Abdominal Aortic Aneurysms

“…Despite this, mortality remains considerably high; therefore, further ideas are required. Although endovascular treatment using a stent-graft has been reported [22,23], the premise for endovascular treatment is the remnant of aneurysm tissue. Even though its usefulness in patients in whom preoperative infection control was favorable has been reported, an important issue remains regarding its application to patients in whom infection control by antibiotics cannot be expected [24].…”

Treatment of Ruptured Infected Abdominal Aortic Aneurysm Caused by Salmonella spp.: A Case Report

“…were responsible for most cases of infected aortic aneurysms. Currently, the main aetiological factor of infected aortic aneurysm is Staphylococcus aureus , while Salmonella ranks second, accounting for about 10% of cases [ 11 ]. However, infected aortic aneurysm still remains the most common manifestation of a systemic Salmonella infection.…”