Mycotic aneurysm of the popliteal artery following right hemicolectomy

Narula, Ashish; Lake, Simone; Baker, A. R.; Greenwood, R. K.

doi:10.1136/pgmj.64.754.638

Cited by 12 publications

(2 citation statements)

References 7 publications

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“…The search yielded 61 articles, and 10 articles were excluded: two non-English articles (one in French and one in Spanish), five academic society presentations, and three articles that were not case reports). Of the remaining 51 articles, we excluded two involving post-endovascular aortic repair (EVAR) infection [ 8 , 9 ], one involving post-axillobifemoral bypass infection [ 10 ], one involving mycotic endocarditis following the reconstructive treatment of congenital heart disease [ 11 ], three involving the mycotic aneurysm of arteries other than the aorta [ 12 – 14 ], and one involving cellulitis [ 15 ], leaving us with 43 articles. In addition to our case, we found a total of 46 cases (Fig.…”

Section: Discussionmentioning

confidence: 99%

Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

et al. 2017

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Background Clostridium septicum-infected aortic aneurysm is a fatal and rare disease. We present a fatal case of C. septicum-infected aortic aneurysm and a pertinent literature review with treatment suggestions for reducing mortality rates.Case presentationA 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. Upon recognition of signs of an abdominal aortic aneurysm and paraplegia, we suspected an occluded Adamkiewicz artery and performed a contrast-enhanced computed tomography scan, which revealed an aortic aneurysm with periaortic gas extending from his chest to his abdomen and both kidneys. Antibiotics were initiated followed by emergency surgery for source control of the infection. However, owing to his poor condition and septic shock, aortic repair was not possible. We performed bilateral nephrectomy as a possible source control, after which we initiated mechanical ventilation, continuous hemodialysis, and hemoperfusion. A culture of the samples taken from the infected region and four consecutive blood cultures yielded C. septicum. His condition gradually improved postoperatively; however, on postoperative day 10, massive hemorrhage due to aortic rupture resulted in his death.ConclusionsIn this patient, C. septicum was thought to have entered his blood through a gastrointestinal tumor, infected the aorta, and spread to his kidneys. However, we were uncertain whether there was an associated malignancy.A literature review of C. septicum-related aneurysms revealed the following: 6-month mortality, 79.5%; periaortic gas present in 92.6% of cases; no standard operative procedure and no guidelines for antimicrobial administration established; and C. septicum was associated with cancer in 82.5% of cases.Thus, we advocate for early diagnosis via the identification of periaortic gas, as an aortic aneurysm progresses rapidly. To reduce the risk of reinfection as well as infection of other sites, there is the need for concurrent surgical management of the aneurysm and any associated malignancy. We recommend debridement of the infectious focus and in situ vascular graft with omental coverage. Postoperatively, orally administered antibiotics must be continued indefinitely (chronic suppression therapy).We believe that these treatments will decrease mortality due to C. septicum-infected aortic aneurysms.

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Section: Discussionmentioning

confidence: 99%

Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

et al. 2017

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“…To the best of our knowledge, only 16 other cases of aneurysm caused by Clostridium septicum have been reported. 1,4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] The aneurysm was located in the abdominal aorta in 6, the thoracic aorta in 4, the thoracoabdominal aorta in 2, the iliac artery in 2, the popliteal artery in 1, and the thoracic aorta and abdominal aorta (double aneurysm) in 1 patient. In addition, two cases of aortic dissection caused by Clostridium septicum infection have been reported.…”

Section: Discussionmentioning

confidence: 99%

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

Takano

Taniguchi

Kuki

et al. 2003

Journal of Vascular Surgery

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We report a surgical case of mycotic aneurysm of the infrarenal abdominal aorta infected by Clostridium septicum. The patient was first treated with an in situ prosthetic graft replacement. When the infection recurred 5 weeks after the aortic surgery, the patient was successfully treated by transposition of rectus abdominis muscle flap around the graft. Only 19 cases of mycotic aneurysm or aortic dissection caused by Clostridium septicum have been reported. Ten of 12 patients who underwent vascular surgery survived, whereas all 7 patients who did not undergo surgery died. Surgical treatment should be undertaken since the surgical results seem satisfactory.

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Mycotic Aneurysms

Cavallaro¹

2020

Aneurysms of the Popliteal Artery

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Mycotic aneurysm of the popliteal artery following right hemicolectomy

Abstract: Summary: A case of mycotic aneurysm of the popliteal artery, following right hemicolectomy for carcinoma, is described. This was treated by ligation and excision without bypass grafting. The clinical features are discussed and the literature reviewed.

Cited by 12 publications

References 7 publications

Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

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

Mycotic Aneurysms

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