Mycotic aneurysm of the infrarenal abdominal aorta infected by Clostridium septicum: A case report of surgical management and review of the literature

Takano, Hiroshi; Taniguchi, Koichi; Kuki, Satoru; Nakamura, Teruya; Miyagawa, Shigeru; Masai, Takafumi

doi:10.1016/s0741-5214(03)00612-8

Cited by 44 publications

(28 citation statements)

References 25 publications

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“…Prognosis of C. septicum aortitis is poor: 14 out of the reported 28 patients died from the infection or its complications [2]. Within C. septicum infections, an increased association to gastrointestinal neoplasms is witnessed by many authors [8][9][10][11][12], probably due to anaerobic metabolism and pH changes in the intestinal wall, which offer a suitable habitat and a ''weak'' area to entry the bloodstream for anaerobic bacteria [8]. In addition, atherosclerotic plaques seem to be a preferential spot for bacterial aortitis caused by the vascular lesion [13].…”

Section: Discussionmentioning

confidence: 99%

Acute aortic dissection caused by Clostridium septicum aortitis

Eplinius

Hädrich

2014

Forensic Science International

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Section: Discussionmentioning

confidence: 99%

Acute aortic dissection caused by Clostridium septicum aortitis

Eplinius

Hädrich

2014

Forensic Science International

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“…Thirty-one cases of mycotic aortic aneurysm infected by C septicum have been previously reported. Progression to aneurysm formation occurs within 1–3 weeks of infection with a 6-month mortality of 100% if left untreated 8. The pathophysiology of the association is not understood.…”

Section: Discussionmentioning

confidence: 99%

Clostridium septicumsepsis and its implications

et al. 2012

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An elderly gentleman, who had 12 years earlier been successfully treated for colon cancer, presented with fever, rigours, right upper quadrant abdominal pain and tenderness. A CT of the abdomen revealed a colonic mass distal to the hepatic flexure with multiple gas locules and a walled off perforation. He underwent a right hemicolectomy. Histology confirmed multifocal colonic adenocarcinoma. His admission blood cultures grew Clostridium septicum. A week postoperatively he developed intermittent fevers and abdominal pain. Repeat CT revealed an abdominal collection adjacent to the new anastomosis, but more importantly, a sharply shouldered aneurysmal dilation of the infra-renal abdominal aorta. These findings prompted immediate surgical drainage of the collection, repair of the anastomostic leak, resection of the infected aortic aneurysm and replacement with a tube graft. This case highlights the clinical significance of C septicum bacteraemia: its association with occult colonic malignancy and with mycotic aneurysm formation. Clostridia isolated from blood cultures should not be dismissed as contaminants but fully identified to ensure appropriate patient management.

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“…In children, C. septicum infections are more often atraumatic, and half of all infections manifest as myonecrosis, with the gastrointestinal tract and CNS being other chief sites of infection [18]. In adults, spontaneous myonecrosis and necrosis of the CNS, joints, eye, pericardium, and aorta are all described with C. septicum infection [15,[19][20][21][22]. Spontaneous C. septicum infection may be rapidly fatal, and mortality rates with myonecrosis are the highest, ranging from 67-100%.…”

Section: Discussionmentioning

confidence: 99%

Clostridium septicum myonecrosis complicating diarrhea-associated hemolytic uremic syndrome

et al. 2008

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We report the case of a 19-month-old male child with diarrhea-associated hemolytic uremic syndrome (HUS) who developed swelling of the right arm at the site of a peripherally inserted central venous catheter (PICC), fever, and later, ecchymosis. Wound cultures at the time of surgical debridement grew Clostridium septicum. The child subsequently required amputation of the right arm and prolonged therapy with parenteral penicillin and clindamycin. Clostridium septicum infections in children with HUS have been associated with a high rate of mortality. Along with colon cancer, diarrhea-associated HUS comprises a clinical entity which appears to predispose to atraumatic C. septicum infection, where acidic and anaerobic conditions in the diseased colon favor C. septicum invasion. Though not well recognized among pediatric nephrologists, C. septicum infection constitutes a severe, albeit rare, complication of diarrhea-associated HUS, but one in which a high index of suspicion is warranted as aggressive surgical and antibiotic therapy may be life-saving.

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Mycotic aneurysm of the infrarenal abdominal aorta infected by Clostridium septicum: A case report of surgical management and review of the literature

Cited by 44 publications

References 25 publications

Acute aortic dissection caused by Clostridium septicum aortitis

Acute aortic dissection caused by Clostridium septicum aortitis

Clostridium septicumsepsis and its implications

Clostridium septicum myonecrosis complicating diarrhea-associated hemolytic uremic syndrome

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