Abstract
A 68-year-old man with an infrarenal mycotic aneurysm underwent successful in-situ graft reconstruction using a woven Dacron graft. A tissue culture taken from the excised aortic wall revealedStaphylococcus epidermidis, and histological study subsequently showed penetrating atherosclerotic ulcers (PAU) involving all layers of the aortic wall and marked neutrophilic infiltration with abscess formation inside the ulcer. Atherosclerotic aortic lesions such as PAU are considered susceptible to bacterial infection, which may lead to the formation of an aneurysm after destruction of the vessel wall. Hence, elderly hypertensive patients, being at high risk for such aortic pathology, require careful studies performed to assess the aorta. The usefulness of computed tomographic (CT) scans to determine the presence of PAU or surrounding inflammation should be borne in mind even when a small mycotic aneurysm exists.
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References
Bennett DE (1967) Primary mycotic aneurysms of the aorta. Report of case and review of the literature. Arch Surg 94:758–765
Reddy DJ, Ernst CB (1995) Infected aneurysms. In: Rutherford RB (ed) Vascular surgery, 4th edn. WB Saunders, Philadelphia, pp 1139–1153
Robinson JA, Johansen K (1991) Aortic sepsis: is there a role for in situ graft reconstruction? J Vasc Surg 13:677–684
Jarrett F, Darling RC, Mundth ED, Austen GW (1975) Experience with infected aneurysms of the abdominal aorta. Arch Surg 110:1281–1286
Sailors DM, Eidt JF, Gagne PJ, Barnes RW, Barone GW, McFarland DR (1996) Primary clostridium septicum aortitis: a rare cause of necrotizing suprarenal aortic infection. J Vasc Surg 23:714–718
Albes J, Haverich A, Freihorst J, von der Hardt H, Manthey-Stires F (1990) Management of mycotic rupture of the ascending aorta after heart-lung transplantation. Ann Thorac Surg 50:982–983
Johansen K, Devin J (1983) Mycotic aortic aneurysms: a reappraisal. Arch Surg 118:583–588
Knosalla C, Weng Y, Yankah AC, Hofmeister J, Hetzer R (1996) Using aortic allograft material to treat mycotic aneurysms of the thoracic aorta. Ann Thorac Surg 61:1146–1152
Ernst CB, Campbell HC Jr, Daugherty ME, Sachatello CR, Griffen WO Jr (1977) Incidence and significance of intraoperative becterial cultures during abdominal aortic aneurysmectomy. Ann Surg 185:626–633
Reddy DJ, Lee RE, and Oh HK (1986) Suprarenal mycotic aortic aneurysm: surgical management and follow-up. J Vasc Surg 3:917–920
Atnip RG (1989) Mycotic aneurysm of suprarenal abdominal aorta: prolonged survival after in-situ aortic and visceral reconstruction. J Vasc Surg 10:635–641
Trairatvorakul P, Sriphojanart S, Sathapatayvongs B (1990) Abdominal aortic aneurysm infected with salmonella: problem of treatment. J Vasc Surg 12:16–19
Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams TW (1989) In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg 47:193–203
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Moriyama, Y., Toda, R., Iwamura, H. et al. Infected atherosclerotic ulcer of the abdominal aorta as a cause of mycotic aneurysm treated by in-situ prosthetic graft reconstruction: Report of a case. Surg Today 28, 325–327 (1998). https://doi.org/10.1007/s005950050132
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DOI: https://doi.org/10.1007/s005950050132