Haemophilus influenzae Serotype f: An Unusual Cause of a Mycotic Aneurysm in an Adult

Adlakha, Arun; Yale, Steven H.; Patel, Robin; Edson, Randall S.; Schultz, Henry J.; Stanson, Anthony W.

doi:10.1016/s0025-6196(12)61644-9

Cited by 12 publications

(5 citation statements)

References 8 publications

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“…H. influenzae is a rarely reported causative agent, with a limited number of isolated case report. [7][8][9][10][11] Furthermore, Degener et al described that a documented case of H. influenzae type B has not been presented in the modern literature. 8 As far as we know, we found only five cases of infective aneurysm due to H. influenzae which included type B, two cases; type F, one case; and unknown, two cases.…”

Section: The Contiguous Direct Spread Of Infection To the Arterialmentioning

confidence: 99%

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Sato

Kobayashi

2012

Int J Angiol

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Infective or mycotic aneurysm is rare but a life-threatening disease. To our knowledge, the incidence of this disease is 0.65 to 2% of all aortic aneurysms. [1][2][3] This disease has an increased tendency to grow rapidly and to rupture. Patients with this disease have severe comorbidities and coexisting sepsis. Conventional surgical treatment, which consists of a radical operation with resection of the aneurysm, extensive local debridement, and revascularization by in situ reconstruction or extra-anatomic bypass is the gold standard but carries a high mortality. Recently, some authors have described that endovascular aneurysm repair (EVAR) for infective abdominal aortic aneurysm (IAAA) was effective in perioperative and mid-term results. 3,4 Salmonella and staphylococcal species are predominant in the cause of IAAA, however, in this case, we detected Haemophilus influenzae. We reported this very rare case with the review of the English literature. Case ReportA 69-year-old man had fever (over 39°C) and, 10 days later, he had severe abdominal and back pain. He consulted nearby doctor and was introduced to our hospital. At the time of initial examination, he did not have fever (36.7°C). On the physical examination, he complained of the spontaneous pain and tenderness at lower abdomen. In laboratory evaluation, white blood cell count and C-reactive protein (CRP) level were elevated, 9700/μL and 12.87 mg/dL, respectively. Furthermore, the level of glycated hemoglobin was 6.2% and he had mild diabetes mellitus. Blood culture result was negative.Abdominal-enhanced computed tomography (CT) scan demonstrated a 35-mm saccular aneurysm of the infrarenal aorta surrounded by inflammatory findings (►Fig. 1A-C). He was diagnosed as having IAAA. First, we treated him with intravenous antibiotic administration for a week. The antibiotic was cefazolin sodium (2 g/day) to cover staphylococcal and Salmonella species. Just before operation, the value of white blood cell count and CRP had decreased down to 6200/μL and 2.54 mg/dL, respectively. We thought that preoperative antibiotic therapy was effective. We performed operation on day 8 after antibiotic administration, and resected the saccular aneurysm with extensive local debridements and irrigation. Revascularization was made in situ reconstruction with expanded polytetrafluoroethylene graft, and entire AbstractInfective abdominal aortic aneurysm (IAAA) is relatively rare, but a case which is caused by Haemophilus influenzae type B is very rare. We experienced one IAAA case due to H. influenzae type B. The patient was 69-year-old man presenting with severe abdominal and back pain and elevated C-reactive protein (CRP), as inflammatory marker. The patient was found to have saccular aneurysm infrarenal aorta on computed tomography scanning. First, we started to treat him with antibiotic agent and second, we operated him at day 8 after admission with expanded polytetrafluoroethylene graft. Revascularization was made in situ reconstruction. As the result of culture with aneurysm wall,...

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Section: The Contiguous Direct Spread Of Infection To the Arterialmentioning

confidence: 99%

A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Sato

Kobayashi

2012

Int J Angiol

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“…With the postvaccine reduction in Hib disease, the proportion of invasive H. influenzae disease caused by Hif rose from 1% in 1989 to 17% in 1994 (40). Invasive Hif disease now contributes to a substantial proportion of all invasive H. influenzae disease (39,43) and has been associated with infections such as bacteremia, endocarditis, and a mycotic aneurysm (1,8,35). Recently, Hif was isolated from a case of rapidly fatal sepsis in an otherwise healthy child (45).…”

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confidence: 99%

GeneticAnalysis of the Capsule Locus of Haemophilus influenzae Serotypef

2003

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A 19-kb DNA region containing genes involved in the biosynthesis of the capsule of Haemophilus influenzae serotype f (Hif) has been cloned and characterized. The Hif cap locus organization is typical of group II capsule biosynthetic loci found in other H. influenzae serotype b bacteria and other gram-negative bacteria. However, the Hif cap locus was not associated with an IS1016 element. Three new open reading frames, Fcs1, Fcs2, and Fcs3, were identified in the Hif capsule-specific region II. The chromosomal location of the Hif cap locus and the organization of the flanking sequences differed significantly from previously described division I H. influenzae serotypes.

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“…Other organisms occasionally isolated from mycotic aneurysms include Streptococcus species and Enterococcus species, Mycobacterium tuberculosis, Clostridium species (Moneta et al, 1998) and some Gram-negative bacilli. H. influenzae has been rarely implicated in this infection, with only a handful of case reports in recent years (Moneta et al, 1998;Whitfield et al, 2008), and only one other case involving H. influenzae type f (Adlakha et al, 1994) to our knowledge.…”

Section: Discussionmentioning

confidence: 88%