Case Of Infected Aortic Aneurysm Research Articles

A Case of Infected Aortic Aneurysm and Multiple Liver Abscesses Due to Early Sepsis after Robot-Assisted Rectal Resection

A Case of Infected Aortic Aneurysm and Multiple Liver Abscesses Due to Early Sepsis after Robot-Assisted Rectal Resection

A case of infected aortic aneurysm complicated by invasive pneumococcal disease observed its formation course on CT

A case of infected aortic aneurysm complicated by invasive pneumococcal disease observed its formation course on CT

A Case of Infected Aortic Aneurysm Caused by Bacteremia due to Perforation of Ascending Colon Cancer

A Case of Infected Aortic Aneurysm Caused by Bacteremia due to Perforation of Ascending Colon Cancer

術前化学療法中に中心静脈ポート感染から感染性大動脈瘤を生じた胃癌の1例

症例は72歳，男性．高度進行胃癌に対して，右上腕に末梢穿刺型中心静脈カテーテル（Peripherally inserted central catheter:以下PICC）を用いた中心静脈（Central venous:以下CV）ポート留置下に術前化学療法を行った．1コース終了後に右上腕の腫脹と疼痛を伴う発熱を認め，CVポート感染に伴う菌血症と血栓性静脈炎と診断．CVポート抜去，抗生剤投与，抗凝固療法を行った．炎症所見が遷延するため第18病日に行った胸腹部造影CTで感染性胸部大動脈炎を認め，治療継続にも関わらず同部位が瘤化し増大，切迫破裂に陥った．第45病日にようやく感染が沈静化し，第67病日のCTでは瘤の増大が停止した．第100病日に大動脈ステントグラフト内挿術を施行し，第130病日には胃癌の根治手術を行った．化学療法目的のCVポートによる重症感染性合併症症例を経験したので報告する．

A case of infected aortic aneurysm with possible intramural abscess resolved through discharge into the vascular lumen without surgical intervention

Infected aortic aneurysms are difficult to treat and, in the absence of aortic resection, are almost always fatal. We report a case of an infected aortic aneurysm cured by antibiotic treatment alone. In this case, the intramural abscess was supposed to be naturally resolved by the discharge of pus into the vascular lumen and infection was suppressed by the antibiotic treatment.

Selective medical treatment of infected aneurysms of the aorta in high risk patients

Infected aneurysm of the aorta is almost always fatal without undergoing aortic resection. Medical treatment was attempted selectively in patients who were considered too high risk for surgery. We review our experience with 22 patients treated without undergoing aortic resection over 12 years. Retrospective chart review. Between 1995 and 2007, 22 cases of infected aortic aneurysms treated without undergoing aortic resection during the first admission were included. There were 17 men with a median age of 76 years (range, 35 to 88 years). Of 18 pathogens isolated, the most common responsible microorganism was nontyphoid Salmonella in 11 followed by Staphylococcus aureus in five. The site of infection was thoracic in eight and abdominal in 14. The hospital mortality rate was 50%, and the aneurysm-related mortality rate after long-term follow-up was 59%. The event-free survival rate at one year was 32%. Of 11 patients with Salmonella infection, eight patients have lived beyond 30 days and six were event-free after one year. Of 11 patients with non-Salmonella, four patients have lived beyond 30 days and only one was event-free after one year. The overall aneurysm-related mortality rate was 36% in Salmonella infected patients and 82% in non-Salmonella infected patients. Clinical results of medical treatment using current antibiotics in patients with infected aortic aneurysm were poor. Traditional surgical excision of infected aortic aneurysms with revascularization remains the gold standard and should be attempted except in high risk patients.

Infected aortic aneurysms

Salmonella organisms have been responsible for half of the reported cases of infected aortic aneurysms, although other bacteria have been incriminated. This is the second reported case in which Campylobacter fetus subspecies fetus apparently infected an inflammatory aortic aneurysm. In this 70-year-old man the organism was isolated and treated prior to resection of the aneurysm and inline grafting. Specific antibiotic therapy was continued for 8 weeks postoperatively. Examination and CT scans obtained after 9 months of follow-up reveal no evidence of recurrent infection.