ro13-9904 and Aortic-Aneurysm--Abdominal

Infectious aortitis is a rare clinical entity that most often manifests itself by an aortic aneurysm. The syphilitic or tubercular forms can be subacute. When it is caused by Salmonella sp., Staphylococcus sp. or Streptococcus pneumoniae, the aortitis is acute with alarming symptoms. Germs found in most cases are Salmonella and Staphylococcus aureus. S. pneumoniae rarely causes infectious aortitis. We report the case of a 75-year-old patient seen in an emergency setting for sudden-onset abdominal pain with fever. An abdominal angio-computed tomography (CT) scan showed a sacciform infrarenal abdominal aortic aneurysm, with an inflammatory aspect and periaortic hematoma. Surgical cure was undertaken because of the impending rupture. An interposition aortic replacement graft was implanted. Blood cultures and bacteriological study of the aortic wall isolated a S. pneumoniae. The anatomical pathology study reported fibrin clot leukocyte remodeling of the aortic wall. An intravenous antibiotic regimen was started. Several organisms, including Streptococcus, can cause infectious aortitis. We found 36 cases described in the literature in addition to our patient.

Topics: Abdominal Pain; Aged; Amoxicillin; Aneurysm, Infected; Anti-Bacterial Agents; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortitis; Bacteremia; Blood Vessel Prosthesis Implantation; Ceftriaxone; Combined Modality Therapy; Fever; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Male; Pneumococcal Infections; Streptococcus pneumoniae; Tomography, X-Ray Computed

The majority of aorto-caval fistulae occur spontaneously, either as a result of rupture of an existing atherosclerotic abdominal aortic aneurysm into the vena cava or secondary to iatrogenic injuries during peripheral angiography or surgery. Aorto-caval fistula from an infected aortic aneurysm is a rare scenario, but potentially lethal.. Case report and review of the literature.. A 63-year-old female with diabetes mellitus and liver cirrhosis was admitted for intractable abdominal pain with rebound tenderness. A computed tomography scan demonstrated an abdominal aortic aneurysm and ill-defined peri-aortic fluid with air density and evidence of a fistula between the aorta and the inferior vena cava. Salmonella cholerasuis had been isolated from a blood culture at a previous admission. Urgent endovascular exclusion of the aorto-caval fistula was carried out, and the infra-renal abdominal aneurysm was repaired using a Cook Zenith TX2 aortic stent graft. She received parenteral ceftriaxone for four weeks.. This case shows acceptable short-term results after endovascular repair of a Salmonella-infected aorto-caval fistula.

Topics: Administration, Intravenous; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Arteriovenous Fistula; Ceftriaxone; Diabetes Complications; Female; Humans; Liver Cirrhosis; Middle Aged; Peritonitis; Radiography, Abdominal; Salmonella enterica; Salmonella Infections; Tomography, X-Ray Computed

Infected aortic aneurysm is a rare disease and is often overlooked as a source of infection in septic elderly patients. We present a case of a septic elderly man with a ruptured infected aortic aneurysm caused by

Topics: Aged, 80 and over; Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Back Pain; Ceftriaxone; Discitis; Drainage; Endovascular Procedures; Humans; Male; Psoas Abscess; Salmonella enteritidis; Sepsis; Tomography, X-Ray Computed

Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Aortitis; Ceftriaxone; Diagnosis, Differential; Emphysema; Humans; Male; Middle Aged; Salmonella Infections; Tomography, X-Ray Computed

Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Bacteremia; Cefazolin; Ceftriaxone; Discitis; Drainage; Humans; Levofloxacin; Male; Middle Aged; Psoas Abscess; Renal Dialysis; Staphylococcal Infections; Staphylococcus aureus

We describe the first documented case of mycotic aneurysm caused by gas-forming serotype K5, and rmpA and iuc positive Klebsiella pneumonia with a hypermucoviscosity phenotype in a diabetic patient. The patient received ceftriaxone for one month and underwent aorto-bi-iliac grafting and inferior mesenteric artery reimplantation and recovered well.

Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Bacterial Capsules; Bacterial Proteins; Ceftriaxone; Diabetes Complications; Gases; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Middle Aged; Phenotype; Serotyping; Tomography, X-Ray Computed; Viscosity

The authors report an unusual case of prosthetic vascular graft infection due to Salmonellatyphimurium. The initial treatment combined antibiotherapy and surgical replacement of the arteriovenous graft. The infection relapsed within 6 weeks and was successfully treated with antibiotics only. Five cases of vascular graft infection due to Salmonella have been reported so far, but only one occurred in a previously healthy man and was not related to local infection, but to bacteremic seeding. Specific features of vascular graft infection and importance of prevention are discussed.

Topics: Aged; Amikacin; Anti-Bacterial Agents; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Cefotaxime; Ceftriaxone; Combined Modality Therapy; Device Removal; Drug Therapy, Combination; Femoral Artery; Humans; Laparotomy; Male; Ofloxacin; Oxacillin; Popliteal Artery; Prosthesis-Related Infections; Recurrence; Salmonella Infections; Salmonella typhimurium; Shock, Septic

The infectious or inflammatory nature of an aortitis is difficult to assert because the microbiological results are often negative. The development of an aneurysm under treatment is rare, but requires a change in the therapeutic strategy and the etiologic diagnosis needs to be discussed again.. We report the case of a 69-year-old woman treated by corticotherapy for an aortitis thought to be inflammatory, who required emergency surgery when a dissected aneurysm appeared. The peroperative samples were positive to Streptococcus pneumoniae using polymerase chain reaction and allowed a change of the diagnosis. The patient evolved favorably under antibiotic therapy.. The decision to treat an aortitis by corticotherapy must be made with caution even if the microbiological tests are negative.

Topics: Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Aortic Dissection; Aortitis; Ceftriaxone; Drug Therapy, Combination; Emergencies; Female; Follow-Up Studies; Gentamicins; Humans; Ofloxacin; Pneumococcal Infections; Streptococcus pneumoniae; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

This study reviewed the clinical outcomes of patients with an aortic aneurysm infected with Salmonella treated by a single centre over 6 years.. Data were collected by a retrospective case-note review.. Between September 1995 and December 2001, 121 patients with non-typhoid Salmonella bacteraemia were treated, of whom 24 patients had an aortic aneurysm infected with Salmonella. Ten had a suprarenal and 14 an infrarenal aortic infection. The most common responsible pathogen was group C Salmonella (12 patients). All of the 20 patients who had combined medical and surgical therapy survived, whereas two of four who had medical therapy alone died. There were two late deaths during a mean follow-up of 23 (range 3-63) months.. The incidence of aortic infection in patients with non-typhoid Salmonella bacteraemia was high in Taiwan. Timely surgical intervention and prolonged intravenous antibiotic therapy resulted in excellent outcomes.

Topics: Abdominal Pain; Adult; Aged; Aged, 80 and over; Ambulatory Care; Aneurysm, Infected; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Bacteremia; Ceftriaxone; Cephalosporins; Combined Modality Therapy; Drug Therapy, Combination; Female; Fever; Follow-Up Studies; Hospitalization; Humans; Male; Middle Aged; Retrospective Studies; Salmonella Infections

The clinical course for a patient hospitalized with pneumonia and meningitis due to penicillin-, ceftriaxone-, and cefotaxime-resistant Streptococcus pneumoniae is described. The pneumonia and meningitis responded to antimicrobial therapy, but the patient died following rupture of an infected abdominal aortic aneurysm; gram-positive cocci resembling S. pneumoniae were detected within the aneurysm.

Topics: Aortic Aneurysm, Abdominal; Cefotaxime; Ceftriaxone; Cephalosporins; Drug Resistance, Microbial; Humans; Male; Meningitis, Bacterial; Middle Aged; Penicillins; Pneumonia, Pneumococcal; Streptococcus pneumoniae