Repetitive Contained Rupture of an Infected Abdominal Aortic Aneurysm With Concomitant Vertebral Erosion

Infectious or Noninfectious? Ruptured, Thrombosed Inflammatory Aortic Aneurysm with Spondylolysis

“…In the literature, an inflammatory aneurysm diagnosed on the basis of CT imaging, with no established infection factor and infiltration of the iliopsoas muscle, has been previously described; however, in that case, there was no damage to surrounding vertebrae [7]. In the present case, the CT images are similar to those of a case described in the literature of an infected retroperitoneal hematoma observed 2 years after aortic aneurysm rupture [6]. In both types of aneurysm (infectious and noninfectious), laboratory tests revealed changes that indicated the presence of an inflammatory process.…”

“…The data in the earliest literature suggest that endovascular treatment of inflammatory aneurysms combined with steroid therapy is most successful [8]. In cases of infectious aneurysms, ligation of an affected artery is advisable, as well as an extra-anatomic bypass to prevent infection of the graft [1, 4, 6]. Additionally, antibiotic treatment consistent with the infection factor should be provided [5].…”

“…However, it is estimated that up to 10 % of infectious aneurysms coexist with bone tissue destruction, most commonly the vertebrae [5]. In atherosclerotic aneurysms, shallow erosions of neighboring vertebral bodies, which develop as a result of chronic compression, can be observed in 0.6 % of cases [6]. The presence of an inflammatory aneurysm with no identified infection factor, as well as infiltration of the iliopsoas muscle and in particular extensive destruction of adjacent vertebrae, has rarely been described in the literature [7, 8].…”

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

“…In this reported case, it was fortuitous that there was delay in communication with the catheter lab sification of mycotic aneurysms remains basically the same: primary bacteremic seeding (such as from endocarditis, pneumonia, and cellulitis) to a weakened vessel wall, secondary traumatic inoculation (such as from intravenous drug use), and contiguous infection from a nearby source [5,14]. S. pneumoniae in particular presently accounts for approximately 9-36% of all mycotic aneurysms [4,12,15,16]; Cartery et al [14] found 52 cases reported in the literature from 1924 to 2007, and we found an additional 16 cases since 2007 [6,[16][17][18][19][20][21][22][23]. Perhaps not surprisingly, the majority of these patients have an antecedent history compatible with a lower respiratory infection in the near past [12,14,24].…”

“…Treatment of mycotic aortic aneurysms requires prompt surgical involvement, as sole medical management with antibiotics is almost inevitably fatal [14,19,23]. After surgical debridement and resection, generally accepted guidelines are for appropriate antibiotic treatment intravenously for at least 6 to 12 weeks until blood cultures clear [14].…”