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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors describe a sixty-seven-year-old hypertensive, diabetic man with a mycotic abdominal aortic aneurysm infected with Clostridium septicum. The patient had colonic polyps but no malignant disease. They could find only one other report of a mycotic aneurysm infected with C. septicum. In that case, as in most other cases of C. septicum bacteremia, the patient had gastrointestinal cancer. Their case suggests that treatment for a clostridial infection should be considered in patients with known gastrointestinal disease, signs and symptoms of sepsis, and abdominal pain. Conversely, patients known to have a C. septicum infection should be evaluated for gastrointestinal lesions.
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PMID:Mycotic aortic aneurysm infected by Clostridium septicum--a case history. 186 18

A patient with acute non-lymphocytic leukemia developed Staphylococcus epidermidis bacteremia and candidemia after maintenance chemotherapy and was treated satisfactorily. He returned 3 months later with abdominal pain due to an abdominal aortic aneurysm. At laparotomy, the aneurysm was found to be infected with Candida albicans. Following surgery, repeated positive blood cultures for C. albicans led to removal of his Hickman catheter. Culture of the catheter tip yielded C. albicans and S. epidermidis. Study of the catheter by scanning and transmission electron microscopy demonstrated yeast-like cells and gram-positive cocci in a biofilm. These studies suggest that the Hickman catheter was the source of the persistent candidemia and that it may have been the origin of the infection of the aneurysm.
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PMID:Special studies of the Hickman catheter of a patient with recurrent bacteremia and candidemia. 371

A patient with Arizonae hinshawii infection of an atherosclerotic abdominal aortic aneurysm is described to emphasize the similarity of the nonenteric infections of man by Arizona and Salmonella organisms. These genera are similar bacteriologically, ecologically, and clinically. This case emphasizes the need for thoroughly considering the differential diagnosis when encountering cryptic bacteremia with either organism.
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PMID:Arizona hinshawii infection of an atherosclerotic abdominal aorta. 721

After emergency repair of a ruptured abdominal aortic aneurysm associated with an aortocaval fistula, Clostridium septicum sepsis prompted evaluation for colon cancer. Adenocarcinoma of the right colon ultimately required hemicolectomy, after which the patient had development of recurrent C. septicum bacteremia. Computed tomography scanning demonstrated a large fluid collection surrounding the aortic graft, and percutaneous drainage documented recurrent C. septicum. Initial axillobifemoral bypass was followed by removal of the patient's aortic graft and retroperitoneal drainage. After 3 years the patient is without evidence of recurrent infection or tumor. This case report consists of a known instance of C. septicum infection of an aortic graft.
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PMID:Clostridium septicum bacteremia associated with aortic graft infection. 756 11

We herein report a case of aortocaval fistula complicated with bacteremia due to Escherichia coli in a 78-year-old man who underwent an emergency operation. A surgical resection of the abdominal aortic aneurysm with a closure of the fistula, and reconstruction with an expanded polytetrafluoroethylene bifurcated graft and wrapping with an omental flap, were performed followed by a 9-week continuous administration of antibiotics. Thereafter, antifungal agents were administered and the results were good. Both an early diagnosis and prompt surgery are important for such patients, and long-term administration of antibacterial agents is also necessary.
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PMID:Aortocaval fistula complicated with bacteremia due to Escherichia coli: report of a case. 1206 91

Salmonellae most commonly cause uncomplicated cases of gastroenteritis but have a predilection for damaged blood vessels, especially those damaged by atherosclerosis. The abdominal aorta is most frequently affected. The most serious complication of aortitis is mycotic aneurysm formation with subsequent rupture. The authors present the case of a 61-year-old man who was found unresponsive at home 3 days after discharge from the hospital for treatment of gastroenteritis with bacteremia. Postmortem examination revealed a ruptured mycotic aneurysm with a large retroperitoneal hematoma. Numerous gram-negative rods were embedded in the wall of the aorta and surrounding inflammatory infiltrate, compatible with the patient's previously isolated. Whereas abdominal aortic aneurysm rupture is most commonly associated with atherosclerosis, the isolation of from blood cultures, coupled with radiographic evidence of gas surrounding the aorta, should raise the suspicion of infectious aortitis. Whereas fatal rupture of an aortic aneurysm secondary to atherosclerosis alone or in conjunction with aortitis will not have an impact on the manner of death, infections are reportable and thus have public health implications.
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PMID:Fatal salmonella aortitis with mycotic aneurysm rupture. 1246 18

This is a case report of a femoral artery infection with fatal outcome after using a percutaneous suture mediated closure device: A 77-year old patient underwent diagnostic angiography of his thoracic and abdominal aortic aneurysm, the puncture site was closed with the Perclose system. He developed a staphylococcal femoral artery infection with groin abscess, requiring surgical intervention with debridement and removal of the Perclose suture. After stent graft exclusion of the thoracic and abdominal aortic aneurysm a staphylococcal sepsis occurred and the patient died of aneurysm rupture months later despite long term antibiotic therapy. Since the use of the Perclose device carries an increased risk of femoral artery infection with septic endarteritis and bacteremia, it should not be used in routine diagnostic angiography.
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PMID:Femoral artery infection associated with a percutaneous arterial suture device. 1522 60

Nontyphoidal salmonellae are among the most common causes of bacterial gastroenteritis worldwide. They are also notable causes of extraintestinal infections, including bacteremia and vascular infections. Salmonella enterica serotype Choleraesuis is typically associated with invasive infections. We report a patient who had an infected intra-abdominal aortic aneurysm due to an unusually mucoid strain of Salmonella enterica serotype Choleraesuis. The isolate was erroneously identified as Hafnia alvei by the Vitek GNI+ card system. A blood culture isolate taken from the same patient 9 months earlier was also identified as H. alvei by the Vitek GNI+ card system. Despite an apparent cure with intravenous amoxicillin-clavulanic acid at that time, the Salmonella infection had not been cleared and manifested as a ruptured infected abdominal aortic aneurysm. Repeated passage of the strain yielded nonmucoid colonies, which were correctly identified by the API and PHOENIX systems. The isolates from the aneurysm and the former bacteremic episode were found to be identical using pulsed field gel electrophoresis. The fallibility of automated bacterial identification systems is highlighted. Such errors are especially important for isolates in which in vitro antibiotic susceptibility testing does not correlate with the clinical success of treatment, as illustrated by Salmonella infections.
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PMID:Misidentification of a mucoid strain of Salmonella enterica serotype choleraesuis as Hafnia alvei by the Vitek GNI+ card system. 1705 Aug 21

Infected aortic aneurysm is an uncommon life-threatening disease. A 68-year-old man had a history of type 2 diabetes mellitus and repeated urinary tract infections. He presented with fever, chills, low back pain, leukocytosis, and Salmonella group B bacteremia. For evaluation of suspected lumbar vertebral osteomyelitis, a 3-phase bone scan and a gallium-67 scan were performed. An abdominal aortic aneurysm was noted incidentally on the blood flow and blood pool phase images. Gallium-67 scan demonstrated increased radioactivity within the soft tissues surrounding the aneurysm, which was suggestive of an infected abdominal aortic aneurysm. The previously unsuspected infected abdominal aortic aneurysm was confirmed by computed tomography.
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PMID:Detection of an infected abdominal aortic aneurysm with three-phase bone scan and gallium-67 scan. 1835 80

A number of micro-organisms have been implicated in the development/progression of abdominal aortic aneurysms (AAAs), thus suggesting an infective theory of AAA pathogenesis. Periodontitis may be involved in the development of AAAs by means of introduction of subgingival plaque periodontal bacteria into the bloodstream and degeneration of the aortic wall. A different theory supports that the findings of periodontal pathogens in AAA biopsies are a secondary phenomenon with transient bacteremia leading to invasion of already formed AAAs. It is not yet clear whether the periodontopathic bacteria accelerate the growth/weakening of the aortic wall or whether they are secondary colonizers of AAAs. Clarification of the association between periodontal disease and AAAs in large-scale studies holds implications for a role for chemoprophylaxis/antibiotic treatment in the management of AAAs.
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PMID:Periodontitis and abdominal aortic aneurysms: a random association or a pathogenetic link? 2008 79


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