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Assessing Bacterial Invasion of Cardiac Cells in Culture and Heart Colonization in Infected Mice Using Listeria monocytogenes
Published on: May 27, 2015
Mycotic aneurysms of the abdominal aorta due to Listeria monocytogenes
Kieran Murphy1, Wissam Al-Jundi, Shah Nawaz
1Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, United Kingdom.
Introduction:
Infected abdominal aortic aneurysms (AAAs) can present insidiously with non-specific symptoms or they may present as ruptured AAA in the classical manner.
Presentation Of Case:
We report two cases of mycotic AAA with Listeria monocytogenes. One patient presented with a ruptured aneurysm, while the other patient had a symptomatic non-ruptured presentation with computer tomography (CT) angiogram demonstrating peri-aortic inflammatory change of a rapidly expanding aneurysm. Both patients were treated with excision of the infected tissue and inlay prosthetic surgical repair as well as long term antibiotics.
Discussion:
Arterial aneurysms caused by L. monocytogenes are rare. Risk factors include immunosuppression, infective endocarditis, intravenous drug use and septicaemia. Listeria infections should be discussed with the Health Protection Agency and local microbiologists due to their ubiquity.
Conclusion:
Abdominal aortic aneurysm due to L. monocytogenes is best managed via surgical resection in combination with long term antimicrobial therapy. The role of endovascular exclusion is unclear.
Insights
Mycotic abdominal aortic aneurysms (AAAs) caused by Listeria monocytogenes are rare but serious. Surgical resection with long-term antibiotics is the recommended treatment for these infected AAAs.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Microbiology
Background:
- Infected abdominal aortic aneurysms (AAAs) present with varied symptoms, from subtle to overt rupture.
- Listeria monocytogenes is a rare cause of arterial aneurysms.
Purpose of the Study:
- To report two cases of mycotic AAA caused by Listeria monocytogenes.
- To discuss the presentation, management, and risk factors associated with Listeria monocytogenes-induced AAAs.
Main Methods:
- Case report of two patients with mycotic AAA due to Listeria monocytogenes.
- Both patients underwent surgical excision of infected tissue and inlay prosthetic repair.
- Long-term antibiotic therapy was administered to both patients.
Main Results:
- One patient presented with a ruptured AAA, the other with a symptomatic non-ruptured AAA.
- Computer tomography (CT) angiogram showed peri-aortic inflammation and rapid aneurysm expansion in the non-ruptured case.
- Both patients were successfully treated with surgery and antibiotics.
Conclusions:
- Listeria monocytogenes-induced abdominal aortic aneurysms require surgical resection and prolonged antimicrobial therapy.
- Risk factors include immunosuppression, infective endocarditis, intravenous drug use, and sepsis.
- Consultation with health protection agencies and microbiologists is advised for Listeria infections.
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