A Rare Case of Clostridium septicum Causing an Abdominal Aortic Endograft Leak

Abstract

The authors report a case of an African American female, status post-EVAR one and a half years prior, who presented to the emergency department with sudden onset of abdominal pain. Computed tomography revealed a type I endoleak and the presence of periaortic gas. The patient underwent an emergent open abdominal aortic endograft explant with in situ tube graft replacement. Blood and endograft tissue cultures grew Clostridium septicum. The patient died perioperatively of systemic multiple organ failure. C. septicum is a rare infection with lethal propensities and has a strong association with paraneoplastic syndromes. The underlying etiology of this patient’s bacteremia was likely associated with an immunodeficiency secondary to myelodysplastic syndrome. Importantly, if periaortic gas is present, the disease is far advanced and the prognosis is poor regardless of treatment; however, a combination of antibiotics and surgery should be initiated immediately. J Med Cases. 2013;4(12):816-819 doi: https://doi.org/10.4021/jmc1608e