Infected aortic aneurysms: clinical outcome and risk factor analysis

Abstract

With timely surgical intervention and prolonged antibiotic treatment, in situ graft replacement provides an excellent outcome in patients with primary infected aortic aneurysms and elective operation. Mortality is still high in patients undergoing urgent operation. Advanced age, non-Salmonella infection, and no operation are major determinants of mortality.

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

“…Mycotic aortic aneurysms (MAA) comprise only a small minority of aortic aneurysms [4,5] and have been associated with an aggressive course with rapid progression. A large contemporary series of MAA have reported a high frequency of rupture at the time of presentation, ranging from 38% to 85% [4, 6,8] with in-hospital mortality as high as 36% to 40% [5,13]. Causative organisms most frequently include Salmonella species and Staphylococcus aureus, with Streptococcus species and E. coli identified less commonly.4,8 In the majority of patients, at least one comorbid condition causing immunosuppression can be identified, including diabetes mellitus, steroid use, and chronic renal failure [4].…”

“…HIV-related aneurysmal disease has been shown to be a distinct pathologic entity from atherosclerotic and mycotic aneurysms [3] and can be distinguished by several features-the presence of multiple aneurysms in atypical locations, younger patient age, fewer traditional atherosclerotic risk factors, and unique histopathology defined by peri-adventitial inflammatory infiltrates [4][5][6][7][8]. It remains unclear to what extent direct viral action versus opportunistic bacterial infection is responsible [2].…”

“…Management of MAA has been a challenging problem for the vascular surgeon, as it often presents late in the course of disease in immunocompromised hosts and carries a high risk of progression to rupture, fulminant sepsis, and death [4,5]. MAA traditionally mandates operative intervention in the form of in situ graft placement or extra-anatomic bypass followed by aortic debridement and ligation, though successful endovascular management has recently been described for non-ruptured MAA [6,7] Commonly implicated organisms include Staphylococcus and Salmonella species, with Escherichia coli less frequently identified [4,8]. In the HIV-infected population, MAA secondary to opportunistic pathogens have also been reported [9,10].…”

Pseudoaneurysmal Formation in Abdominal Aorta Associated with Escherichia coli Infection

“…The prevalence of IAA in the abdominal aorta is 0.7-1.3% of all surgically treated aortic aneurysms (1)(2)(3)(4)(5). The mortality of IAA is high and depends upon the artery involved, treatments received, and underlying conditions.…”

Mycotic Abdominal Aneurysm Caused by Campylobacter Fetus: A Case Report for Surgical Management

“…[6][7][8][9][10][11][12][13] Campylobacter fetus, a helical, microaerophilic, Gram-negative rod, is reported to cause miscarriage in livestock, especially in cattle and sheep. 6,7) In humans, it is associated with a decline in the physical condition, eventually leading to endocarditis and meningitis. 1,2) We have found 15 cases of Campylobacter fetus infection inducing mycotic AAA (13, male; 2, female; average age, 64.4 years; range, 45−84 years).…”