Stent-graft for recurrent melioidosis mycotic aortic aneurysm

Area of Science:

• Infectious Diseases
• Vascular Surgery
• Medical Microbiology

Background:

• Melioidosis is an infectious disease endemic in tropical regions, caused by Burkholderia pseudomallei.
• The bacterium can infect multiple organ systems, leading to severe and potentially fatal complications.
• Mycotic aneurysms, particularly of the aorta, are an uncommon manifestation of melioidosis.

Observation:

• A patient presented with fever and right pleural effusion.
• The patient was diagnosed with a mycotic aneurysm of the descending aorta due to melioidosis.
• This presentation is a rare occurrence of the disease.

Findings:

• Successful initial management involved Dacron graft repair with omental reinforcement.
• A late anastomotic leak was subsequently managed with endovascular stent grafting.
• This combined approach proved effective in treating the complex aortic aneurysm.

Implications:

• This case demonstrates a viable treatment strategy for rare melioidosis-induced aortic aneurysms.
• It highlights the importance of considering melioidosis in endemic areas for patients with unexplained fevers and vascular complications.
• The successful dual-modality treatment offers insights for managing similar complex vascular infections.