piperacillin--tazobactam-drug-combination and Aortic-Aneurysm--Abdominal

Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Aortography; Blood Vessel Prosthesis Implantation; C-Reactive Protein; Ciprofloxacin; Diagnostic Imaging; Haemophilus Infections; Haemophilus influenzae; Humans; Leukocyte Count; Male; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Ribotyping; Tomography, X-Ray Computed

The development of an abdominal aortic aneurysm secondary to infectious aortitis following solid organ transplantation is a rare event that in the absence of surgical intervention, can lead to uncontrolled sepsis, catastrophic hemorrhage and death. Arterial allografts have been a viable surgical option for the past 30 years, although operative modalities have undergone a paradigm shift in recent years. We describe the first case in the literature of a liver transplant recipient who developed an infrarenal aortic aneurysm secondary to Salmonella bacteraemia, which was treated successfully with aortic allograft transplantation.

Topics: Aged; Aorta; Aorta, Thoracic; Aortic Aneurysm, Abdominal; Aortitis; Bacteremia; Female; Humans; Liver; Liver Transplantation; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Radiography; Salmonella enteritidis; Salmonella Infections; Transplantation, Homologous

Acute infection of an aortic graft is a devastating complication. While resection of the infected prosthesis and extra-anatomic bypass is the established treatment, this carries a high mortality. We describe a case of early aortic graft infection with the unusual organism Acinetobacter baumanii, which was eradicated by a combination of surgical drainage and antibiotics, allowing preservation of the graft. The patient remains well 30 months later.

Topics: Acinetobacter baumannii; Aged; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Combined Modality Therapy; Debridement; Female; Gentamicins; Humans; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Prosthesis-Related Infections; Rifampin; Treatment Outcome