trimethoprim--sulfamethoxazole-drug-combination and Aortic-Aneurysm--Abdominal

Topics: Aged; Ampicillin; Aneurysm, Infected; Anti-Bacterial Agents; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Combined Modality Therapy; Humans; Listeria monocytogenes; Listeriosis; Male; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

A 67-year-old man presented to our hospital with general malaise, fever and diffuse abdominal and lower back pain 7 weeks after endovascular aneurysm repair. Blood samples showed a leukocyte count of 10.9 x 10(9)/l and a C-reactive protein of 239 mg/l. The computed tomography (CT)-scan showed fluid collections behind the proximal part of the endovascular graft and dorsal to the aorta. CT-guided translumbar needle aspiration of these collections yielded growth with Listeria monocytogenes. Prosthetic endograft infection is an extremely rare event, especially when it is caused by L. monocytogenes. Given the scarcity of this complication, no consensus has been reached for its treatment. In the described case, radiological drainage and prolonged antibiotic treatment resulted in favourable outcome at midterm follow-up with preservation of the endograft.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Aortography; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Drainage; Humans; Listeriosis; Male; Positron-Emission Tomography; Prosthesis-Related Infections; Stents; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination

Aortic stent graft infection is rare and there are no reported cases of seeded peripheral mycotic aneurysms complicating this condition. We describe the case of a 54 year old man who developed a late stent graft infection at three years, resulting in the peripheral seeding of three mycotic aneurysms with two incidents of rupture. He was successfully treated with extra-anatomic bypass of the aorta and both surgical and endovascular repair of his peripherally seeded mycotic aneurysms.

Topics: Aneurysm, Infected; Aneurysm, Ruptured; Anti-Infective Agents; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Enterococcus faecalis; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Prosthesis-Related Infections; Radiography; Reoperation; Rupture, Spontaneous; Stents; Tibial Arteries; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of chronic-contained rupture of an infected aneurysm of the abdominal aorta, from which Listeria monocytogenes was cultured. The diagnosis of rupture and retroperitoneal mass was made by computed tomography, whereas FDG -PET diagnosed vessel wall inflammation. The infectious nature only became apparent at surgery.

Topics: Aged; Ampicillin; Aneurysm, Infected; Anti-Bacterial Agents; Anti-Infective Agents; Aortic Aneurysm, Abdominal; Aortic Rupture; Chronic Disease; Female; Fluorodeoxyglucose F18; Humans; Listeriosis; Positron-Emission Tomography; Radiopharmaceuticals; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination