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Published on: June 24, 2020
Bilateral internal iliac artery aneurysm infected with Campylobacter fetus
Alexander Shiferson1, Enrico Ascher, Anil Hingorani
1Division of Vascular Surgery, Department of Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Abstract:
This is a case report of a patient with Campylobacter fetus involving bilateral internal iliac artery aneurysms. The patient was treated successfully by ligation of the bilateral iliac artery aneurysms and antibiotics. According to a review of the English-language medical literature, this was the first such patient to be reported. A 69-year-old African-American male presented with a past medical history of repair of a 6.6 cm abdominal aortic aneurysm. It had been repaired with a Dacron bifurcated graft in July 2005. The bilateral internal iliac artery aneurysms (right 2.3 cm and left 3.4 cm) were coil embolized intraoperatively. The patient's past medical history was significant for hypertension and coronary artery disease and was status post-stent placement. He re-presented with fever and chills for 8 days in duration at home in March 2007. His fever was 101 to 102 degrees F. He denied vomiting, diarrhea, and a history of recent travel. The patient was admitted to the hospital for a fever workup. After an extensive workup, a left internal iliac artery aneurysm was found to be the source of sepsis. The patient was taken to the operating room for excision of the left internal iliac artery. No purulence was noted, but tissue overlying the aneurysm was thickened and fibrotic. Multiple cultures were taken. The tissue culture came back as C. fetus. Incidentally, the patient's preoperative computed tomographic scan revealed a right internal iliac artery aneurysm that was 4.2 cm on March 28, 2007, and 4.9 cm on April 23, 2007. Postoperatively, the patient's right internal iliac artery aneurysm was noted to be rapidly growing. He was promptly taken to the operating room for ligation of the right internal iliac artery aneurysm. The patient's postoperative course was unremarkable. He was discharged on ciprofloxacin for 14 days.
Insights
This case report details a rare Campylobacter fetus infection causing bilateral internal iliac artery aneurysms. Successful treatment involved aneurysm ligation and antibiotics, marking a first in medical literature.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Medical Case Reports
Background:
- Campylobacter fetus is a rare cause of arterial infections.
- Internal iliac artery aneurysms can be challenging to diagnose and treat.
- Previous literature lacks reports of C. fetus infection specifically involving bilateral internal iliac artery aneurysms.
Observation:
- A 69-year-old male with a history of abdominal aortic aneurysm repair presented with sepsis.
- Infection was traced to a left internal iliac artery aneurysm, with tissue cultures positive for C. fetus.
- A contralateral right internal iliac artery aneurysm was also identified and rapidly growing.
Findings:
- The patient underwent successful surgical ligation of both internal iliac artery aneurysms.
- Antibiotic therapy with ciprofloxacin was administered for 14 days.
- This represents the first reported case of Campylobacter fetus infection involving bilateral internal iliac artery aneurysms.
Implications:
- Highlights the importance of considering C. fetus in cases of arterial aneurysms, especially in patients with risk factors.
- Demonstrates the efficacy of surgical intervention combined with antibiotics for managing such rare infections.
- Underscores the need for vigilant monitoring of contralateral aneurysms in patients with unilateral disease.
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