Infected Aneurysm

Laohapensang, Kamphol; Rutherford, Robert B.; Arworn, Supapong

doi:10.3400/avd.ctiia09002

Cited by 30 publications

(28 citation statements)

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“…Cases of Salmonella mycotic aneurysms in literature are dominated by males above the age of 60, who suffer from hypertension, diabetes mellitus and atherosclerosis similar co-morbidities to our patient [4,5]. Atherosclerosis predisposes to endothelial invasion by Salmonella [8] and in this case was one of the most significant risk factors.…”

Section: Discussionsupporting

confidence: 57%

A mycotic aneurysm related to Salmonella Rissen infection: a case report

et al. 2020

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Background: Salmonella species commonly causes infection in humans and on occasion leads to serious complications, such as mycotic aneurysms. Here, we present the first case reported of a patient with a mycotic aneurysm likely secondary to Salmonella Rissen infection. Case presentation: The patient presented with 4 weeks of lower back pain, chills and a single episode of diarrhoea 2 months prior during a 14-day trip to Hong Kong and Taiwan. Magnetic resonance imaging revealed an aneurysmal left internal iliac artery with adjacent left iliacus rim-enhancing collection. A stool culture was positive for Salmonella Rissen ST 469 EBG 66 on whole genome sequencing. The patient underwent an emergency bifurcated graft of his internal iliac aneurysm and was successfully treated with appropriate antibiotics. Conclusions: This case highlights the importance of considering the diagnosis of a mycotic aneurysm in an unusual presentation of back pain with features of infection.

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Section: Discussionsupporting

confidence: 57%

A mycotic aneurysm related to Salmonella Rissen infection: a case report

et al. 2020

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“…5,36) Longer durations and even life-long antibiotic-therapy have been recommended by others. 3,15,[36][37][38] Some authors believe that patients with a prosthetic reconstruction should continue on low-dose antibiotics for life. However, the advantage of a more prolonged therapy has not been confirmed.…”

Section: Discussionmentioning

confidence: 99%

Management of the Infected Aortoiliac Aneurysms

Laohapensang

Aworn

Orrapin

et al. 2012

Annals of Vascular Diseases

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We have reviewed ruptured and nonruptured infected aortoiliac aneurysms to study the clinical presentation, management and eventual outcome of patients managed with in situ prostheses, axillofemoral prostheses grafts and endovascular reconstruction. Design: A retrospective chart review of 16 cases treated at a single institution. Methods: From January 2007 to March 2008, a total of 93 patients with aortoiliac aneurysms underwent surgical repair at our institution. Among these, 16 patients (17.2%) were shown to be infected aneurysms of the infrarenal (n = 6), juxtarenal (n = 2), and pararenal aorta (n = 1); the others were 5 common, 1 external, and 1 internal iliac arteries. Fourteen patients were male and 2 were female with the mean age of 66 years (range, 45-79). In all cases, the diagnosis was confirmed by abdominal computed tomography and empirical parenteral antibiotics were administered at least 1 week, unless in patients need emergency operations. At the time of an operation, all were saccular and were classified as primary infected aortoiliac aneurysms. Thirteen patients had surgical debridement with in situ graft interposition and omental wrapping, 2 underwent aneurysm exclusion and extra-anatomic (axillo-femoral) bypass, 1 underwent aneurysmectomy of left external iliac artery and polytetrafluoroethylene (PTFE) graft interposition, and 1 underwent endovascular exclusion. The parenteral antibiotics were continued in the postoperative period for 4-6 weeks. Chronic renal disease was present in 37.5% (6/16), with diabetes mellitus present in 31.25% (5/16). The most common pathogen was Salmonella sp. (n = 6) and E. coli (n = 5). Thirty-seven percent (6/16) of the patients presented late, with a 37.5% (6/16) incidence of ruptured (4 contained, 2 free ruptured) that needed emergency surgery. Results: Disease-specific mortality was 31.25% (5/16). The 30-day mortality rate of ruptured cases is high 67% (4/6), because patients present late in the course of the disease. One patient who underwent aneurysm exclusion and extra-anatomic (axillo-femoral) bypass died 6 months later from burst aortic stump. Salmonella and E. coli are the most common pathogens. Conclusions: Early diagnosis followed by surgical intervention with proper antibiotic coverage provides the best results. Mortality rate was still high in patients with sepsis and rupture. An in situ graft interposition and omental wrapping is a safe option for revascularization of infected aneurysms of the iliac arteries and infrarenal aorta.

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“…4 The vascular endothelial infection is favored by preexisting atherosclerotic arterial lesions and it can be complicated by the development of an aneurysm or by the enlargement of a preexisting aneurysm. 5 Aortitis is the most common aspect of Salmonella endarteritis. 6 Salmonella spp.…”

Section: Discussionmentioning

confidence: 99%