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.

Abstract

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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