Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report

Area of Science:

• Cardiovascular Surgery
• Pediatric Infectious Diseases
• Vascular Surgery

Background:

• Abdominal aortic aneurysms (AAAs) are uncommon in children, with infectious (mycotic) AAAs posing a significant rupture risk.
• Pediatric mycotic AAAs can rapidly expand, leading to aortic wall compromise and potential rupture.
• Early detection and intervention are critical for managing this rare but life-threatening condition in infants.

Observation:

• A 10-month-old infant, previously treated for hypoplastic left heart syndrome, developed methicillin-resistant Staphylococcus aureus bacteremia post-cardiac catheterization.
• An abdominal ultrasound, initially for renovascular hypertension, incidentally revealed a mycotic AAA.
• A prior CT scan showed normal aortic contours, indicating rapid aneurysm development.

Findings:

• The infant presented with a rapidly expanding mycotic AAA, a rare complication in pediatric patients.
• The mycotic AAA was diagnosed via abdominal ultrasound following a recent episode of bacteremia.
• Despite a recent normal CT scan, the aneurysm developed quickly, highlighting the aggressive nature of infectious AAAs.

Implications:

• This case underscores the importance of considering infectious etiologies for aortic abnormalities in pediatric patients, especially those with recent bacteremia.
• Prompt surgical intervention, such as open aneurysmorrhaphy with patch angioplasty, can effectively treat pediatric mycotic AAAs.
• Further research into the pathogenesis and optimal management strategies for pediatric mycotic AAAs is warranted.