Molecular diagnosis and characterization of a culture-negative mycotic aneurysm due to ST54 Haemophilus influenzae type b with PBP 3 alterations

Hirai, Nobuyasu; Kasahara, Kei; Fujikura, Hiroyuki; Yoshihara, Shingo; Ogawa, Taku; Ogawa, Yoshihiko; Hishiya, Naokuni; Suzuki, Yuki; Nakano, Ryuichi; Yano, Hisakazu; Yoshikawa, Masahide; Mikasa, Keiichi

doi:10.1016/j.jiac.2017.12.013

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Culture negative endocarditis is a typical instance demonstrating the usefulness of the 16S rRNA gene PCR [ 18 ]. Also, in culture of negative mycotic aneurysms, PCR has been applied for establishing a bacterial etiology, for example, Streptococcus penumoniae and Haemophilus influenzae [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Mycotic abdominal aortic aneurysm caused by Borrelia afzelii: a case report

et al. 2022

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Background Inflammatory aneurysms and mycotic aneurysms make up a minority of abdominal aortic aneurysms. Mainly autoimmune mechanisms are proposed in the pathogenesis of inflammatory aneurysms, and it is not routine to check for infectious agents as disease culprits. Case presentation A 58-year-old European male with complaints of abdominal and back pain for 8 weeks was admitted after a semi-urgent computed tomography scan revealed an 85 mm inflammatory abdominal aortic aneurysm. The patient had normal vital signs, slightly elevated inflammatory markers, and mild anemia on admission. Clinical examination revealed a tender pulsating mass in his abdomen. His clinical condition was interpreted as impending rupture and urgent repair of the aneurysm was deemed necessary. Due to the patient’s relatively young age and aneurysm neck morphology, open aortic repair was preferred. Preoperatively, the aneurysm appeared inflamed, with fibrous wall thickening and perianeurysmal adhesions. Aneurysm wall biopsies were sent to histopathological and microbiological diagnostics. Routine cultures were negative, but 16S rRNA gene real-time polymerase chain reaction was positive and Borrelia afzelii was identified by DNA sequencing of the polymerase chain reaction product. B. afzelii was also identified by sequencing the polymerase chain reaction product of a Borrelia-specific groEL target. Immunoglobulin G and M anti-Borrelia antibodies were present on serological analysis. Histopathological analysis displayed loss of normal aortic wall structure and diffuse infiltration of lymphocytes and plasma cells. The patient had an uneventful recovery and was discharged after 1 week to a regional rehabilitation facility. Though the patient fares clinically well and inflammatory markers had normalized, antimicrobial treatment with doxycycline continues at 3 months follow-up due to remaining radiologic signs of inflammation. Conclusions Borrelia infection in the setting of acute aortic pathology is a rare entity. To our knowledge, this is the first case report to demonstrate a mycotic abdominal aortic aneurysm as a rare manifestation of Lyme disease. Aortic wall biopsies and real-time polymerase chain reaction analysis of the specimen were essential for accurate diagnosis. This finding may contribute to the understanding of the etiology of inflammatory aneurysmal disease and abdominal aneurysms in general.

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Section: Discussionmentioning

confidence: 99%

Mycotic abdominal aortic aneurysm caused by Borrelia afzelii: a case report

et al. 2022

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“…With the increasing incidence of infective endocarditis, the complication of infective aneurysm is gradually receiving attention [3]. The diagnosis is confirmed based on computed tomography (CT) imaging, blood cultures, or surgical tissue identification [4,5]. Ultrasound may indicate an aneurysm, but it cannot confirm whether it is caused by an infectious cause.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Infective Aneurysm of Mesenteric Artery Due to Infective Endocarditis: Diagnosis and Treatment

Wu,

Miao,

2024

HSF

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The infected aneurysm is a rare disease; antibiotic therapy combined with surgical treatment is the most common treatment currently available after computed tomography (CT) imaging and blood culture confirmation. We herein report a case of a 25-year-old male with infective endocarditis that caused an infective aneurysm of the mesenteric artery. We hope to help with the diagnosis and treatment of similar patients.

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“…The different types of infected aneurysms, infective endocarditis still accounts for a larger proportion [1]. The diagnosis is con rmed based on computed tomography (CT) imaging, blood cultures, or surgical tissue identi cation [2,3]. Ultrasound could suggest the aneurysm, yet it is not signi cantly de nite for determining whether it is infective.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of infective aneurysm of mesenteric artery due to infective endocarditis

Wu,

Miao,

2023

Preprint

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Background The incidence of infected aneurysms is low. Risk factors include atherosclerosis, arterial damage as well as previous infection. The different types of infected aneurysms, infective endocarditis still accounts for a larger proportion. The diagnosis and treatment methods have not been standardized yet. Case presentation: A 25-year-old young man presented with a fever (up to 39.0°C). Even after three months, the fever persisted and included abdominal pain and diarrhea. CT angiography of the thoracoabdominal aorta suggested the formation of a pseudoaneurysm, potentially a branch of the superior mesenteric artery. Considering the patient's presence of distant infarction and the formation of infectious pseudoaneurysm, the patient underwent early surgery. The patients underwent aortic valve replacement and partial small bowel resection. The coagulation function was monitored in the outpatient clinic after the operation, and the patient returned to normal life during the postoperative follow-up. Conclusions In patients with a history of endocarditis and a chief complaint of abdominal pain and fever, embolism due to septic embolic drop should be included in the differential diagnosis. Before the onset of symptoms, patients should be treated prophylactically, preventing surgical treatments such as bowel resection.

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Molecular diagnosis and characterization of a culture-negative mycotic aneurysm due to ST54 Haemophilus influenzae type b with PBP 3 alterations

Cited by 5 publications

References 24 publications

Mycotic abdominal aortic aneurysm caused by Borrelia afzelii: a case report

Mycotic abdominal aortic aneurysm caused by Borrelia afzelii: a case report

A Rare Case of Infective Aneurysm of Mesenteric Artery Due to Infective Endocarditis: Diagnosis and Treatment

Diagnosis and treatment of infective aneurysm of mesenteric artery due to infective endocarditis

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