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Published on: December 18, 2010

Abdominal aortitis due to Streptococcus pneumoniae and Enterobacter aerogenes: a case report and review

Matthew T Rondina1, Kalani Raphael, Robert Pendleton

  • 1Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA. matthew.rondina@hsc.utah.edu

Journal of General Internal Medicine
|July 1, 2006
PubMed

Insights

This case study highlights a rare polymicrobial infectious aortitis caused by Streptococcus pneumoniae and Enterobacter aerogenes. Early surgical intervention and antibiotics are crucial for treating this life-threatening condition.

Area of Science:

  • Infectious Diseases
  • Vascular Surgery
  • Microbiology

Background:

  • Endovascular infections are a significant cause of fever of unknown origin.
  • Infectious aortitis, particularly spontaneous abdominal aortitis, is uncommon and often presents diagnostic challenges.

Observation:

  • A 72-year-old male presented with epigastric pain, fever, and chills.
  • Computed tomography revealed an enlarged and ulcerated distal abdominal aorta, necessitating urgent vascular surgery.
  • Intraoperative cultures identified Streptococcus pneumoniae and Enterobacter aerogenes.

Findings:

  • This case represents the second reported instance of polymicrobial infectious aortitis.
  • Enterobacter species have previously been documented primarily in infected aortic grafts.
  • The patient received a 6-week course of gatifloxacin post-surgery.

Implications:

  • Clinicians must maintain a high index of suspicion for infectious aortitis due to its high mortality rate if treated non-surgically.
  • This case expands the understanding of polymicrobial involvement in spontaneous aortitis.
  • Prompt diagnosis and combined surgical and antimicrobial therapy are essential for favorable outcomes.

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