Abstract
An 88-year-old man was admitted with general fatigue. Computed tomography (CT) showed a descending aortic aneurysm. The laboratory data indicated severe infection. Despite negative blood cultures, broad-spectrum intravenous antibiotic therapy was started. Though antibiotic therapy was continued for about 2 weeks, the aneurysm extended 20 mm. Thoracic endovascular aortic repair was performed, and antibiotic therapy was continued for 4 weeks after the procedure, followed by oral antibiotics for 1 year. CT showed regression of the aneurysm 15 months after reconstruction. Antibiotic therapy, preoperatively and postoperatively, is important for a mycotic aortic aneurysm.
Highlights
A mycotic aortic aneurysm is a rare but life-threatening condition
The most common organisms found to be responsible for mycotic aneurysms are Salmonella spp. and Staphylococcus aureus, but blood cultures are negative in some cases of mycotic aneurysms [1,2]; 77% of patients have at least one positive culture, such as blood, aneurysm wall or bronchial washings [3]
The standard treatment for mycotic aortic aneurysm has been open surgical treatment with debridement of infected tissue and in situ repair with an antibiotic-soaked prosthesis followed by long-term antibiotics [1]
Summary
A mycotic aortic aneurysm is a rare but life-threatening condition. Traditional treatment of mycotic aortic aneurysms is open surgical treatment. Though antibiotic therapy was continued for about 2 weeks, the aneurysm extended 20 mm. Thoracic endovascular aortic repair was performed, and antibiotic therapy was continued for 4 weeks after the procedure, followed by oral antibiotics for 1 year. Antibiotic therapy, preoperatively and postoperatively, is important for a mycotic aortic aneurysm.
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