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An infected abdominal aortic aneurysm and hepatic abscesses due to streptococcus milleri

R D Low1, D A Coventry, D Spelman

  • 1Alfred Hospital, Melbourne, Victoria, Australia.

The Australian and New Zealand Journal of Surgery
|February 23, 2010
PubMed

Insights

A 78-year-old man with fever and hepatic abscesses had an infected abdominal aortic aneurysm caused by Streptococcus milleri. Treatment with a Dacron graft and penicillin was successful, suggesting suitability for Gram-positive infections without peritoneal contamination.

Area of Science:

  • Infectious Diseases
  • Vascular Surgery
  • Microbiology

Background:

  • Infected abdominal aortic aneurysms (IAAA) are rare but serious conditions.
  • Streptococcus milleri is a known pathogen that can cause serious infections.
  • Hepatic abscesses can be a manifestation of systemic infections.

Observation:

  • A 78-year-old male presented with fever and hepatic abscesses.
  • Infection of an abdominal aortic aneurysm was diagnosed.
  • Streptococcus milleri was identified as the causative organism.

Findings:

  • The patient was treated with an in situ Dacron graft.
  • High-dose intravenous penicillin was administered.
  • Successful treatment was achieved with this approach.

Implications:

  • This case suggests that surgical repair with an in situ graft combined with high-dose penicillin may be an effective treatment strategy for IAAs caused by Gram-positive organisms.
  • This approach may be particularly suitable in cases without extensive peritoneal soiling.
  • Further research into optimal management of IAAs caused by specific pathogens is warranted.

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