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Propensity of Streptococcus pneumoniae for the aorta. Report of 3 cases
T A Steig1, N Johannesen, H C Schønheyder
1Department of Clinical Microbiology, Aalborg Hospital, Denmark. tas2@mail.tele.dk
Abstract:
Streptococcus pneumoniae was the unsuspected cause of a ruptured aortic aneurysm in 3 patients, as confirmed by culture of specimens obtained during surgery. A 60-y-old woman had a recently diagnosed saccular aortic aneurysm and presented with symptoms indicating a vascular catastrophe. A 66-y-old man and a 69-y-old woman were both admitted with pyrexia and abdominal pain and proper diagnosis was delayed for 4 and 15 d, respectively. All 3 patients were treated with graft insertion and antibiotic therapy for 3 months and recovered fully.
Insights
Streptococcus pneumoniae can unexpectedly cause ruptured aortic aneurysms. Prompt surgical repair and antibiotic treatment led to full recovery in three patients with this rare bacterial infection.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Surgical Pathology
Background:
- Aortic aneurysms, particularly when ruptured, represent a critical medical emergency.
- Bacterial infections are a known, though less common, cause of aortic aneurysms.
- Timely diagnosis and intervention are crucial for managing ruptured aortic aneurysms.
Observation:
- Three patients presented with ruptured aortic aneurysms.
- Cultures from surgical specimens identified Streptococcus pneumoniae as the causative agent in all three cases.
- Diagnostic delays occurred in two patients, highlighting potential challenges in recognizing this etiology.
Findings:
- Streptococcus pneumoniae was confirmed as the cause of ruptured aortic aneurysms in three patients.
- Surgical intervention with graft placement was performed on all patients.
- A three-month course of antibiotic therapy was administered post-surgery.
Implications:
- This study highlights Streptococcus pneumoniae as an important, albeit uncommon, pathogen in aortic aneurysm rupture.
- Early identification and targeted antibiotic therapy alongside surgical management are key to successful outcomes.
- Clinicians should consider infectious etiologies in patients presenting with aortic emergencies, even in the absence of typical infection signs.