Abstract
We present a case of leaking mycotic aneurysm of abdominal aorta complicated by infective endocarditis in a young boy of 14 years age. This boy with history of rheumatic heart disease with vegetations on mitral valve and severe mitral regurgitation landed up in complications of infective endocarditis like femoral artery thrombo embolism followed by an abdominal aortic aneurysm with contained rupture. This case was successfully managed addressing two problems i.e. valve and aneurysm repair in single sitting.
Highlights
We present a case of leaking mycotic aneurysm of abdominal aorta complicated by infective endocarditis in a young boy of 14 years age
Since patient is a known case of rheumatic heart disease with heart failure (NYHA CLASS III), severe mitral regurgitation complicated by bacterial endocarditis and history of embolic events it was decided to repair mitral valve and abdominal aortic aneurysm in single setting
In view of rarity of mycotic aneurysm in this era of antibiotics we hardly found any similar case like ours in the literature
Summary
This 14 year old boy has come to our hospital with complaints of abdominal distension and vague abdominal discomfort for one day. He gave history of high grade continuous fever which was managed with antipyretics and antibiotics in a private clinic This boy was previously admitted in our hospital one month before with claudicating pain in right lower limb, Doppler examination showed a thrombus in right femoral artery and subsequently he has undergone trans femoral embolectomy. He was put on oral anticoagulants with Tab.Acitrom (Nicoumalone) 1 mg o.d. Two weeks after embolectomy he developed high grade fever with chills, blood cultures revealed the growth of Klebsiella and was treated with antibiotics according to culture sensitivity. Patient was discharged from hospital on 10th post operative day and a check aortogram was done 3 months later during follow up showed good graft function echocardiogram showed mild mitral regurgitation and tricuspid regurgitation with improved left ventricular function
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