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Multiple peripheral pneumococcal mycotic aneurysms without aortic involvement: a unique case confirmed with the novel

Karen J Dickinson1, Duncan J Parry, Jonathan A Sandoe

  • 1Leeds Vascular Institute, Microbiology Department, Leeds General Infirmary, Leeds, United Kingdom.

Journal of Vascular Surgery
|June 5, 2007
PubMed

Insights

This study details a rare case of Streptococcus pneumoniae causing femoral and popliteal artery aneurysms. Molecular detection of bacterial DNA confirmed the diagnosis despite negative cultures, highlighting advanced diagnostic importance.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Mycotic aneurysms present significant morbidity and mortality risks.
  • Streptococcus pneumoniae-induced aortic aneurysms are rare and challenging to diagnose due to prior antibiotic use.
  • Pneumococcal infections can lead to severe vascular complications.

Observation:

  • A unique case of mycotic femoral and popliteal artery aneurysms following pneumococcal pneumonia and meningitis is presented.
  • Surgical management involved resection and autologous vein revascularization.
  • Despite negative blood and aneurysm sac cultures, Streptococcus pneumoniae was detected in arterial walls.

Findings:

  • Polymerase chain reaction (PCR) successfully detected Streptococcus pneumoniae DNA in the arterial wall.
  • This molecular technique facilitated diagnosis in the absence of positive cultures.
  • Intravenous benzylpenicillin was administered as part of the treatment regimen.

Implications:

  • Molecular diagnostic techniques are crucial for identifying pathogens in culture-negative mycotic aneurysms.
  • Accurate diagnosis enables targeted antimicrobial therapy, which is vital given rising antimicrobial resistance.
  • Early and precise diagnosis improves patient outcomes for rare vascular infections.

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