Infected abdominal aortic aneurysm caused by Streptococcus pneumoniae diagnosed using polymerase chain reaction

Area of Science:

• Infectious Diseases
• Vascular Surgery
• Molecular Diagnostics

Background:

• Streptococcus pneumoniae can cause meningitis.
• Infected abdominal aortic aneurysms are rare but serious complications.
• Early diagnosis and treatment are crucial for patient outcomes.

Purpose of the Study:

• To report a case of infected abdominal aortic aneurysm secondary to Streptococcus pneumoniae meningitis.
• To highlight the utility of molecular diagnostic techniques in identifying pathogens when traditional cultures are negative.
• To emphasize the importance of timely diagnosis for guiding appropriate antibiotic therapy.

Main Methods:

• Case report of a 55-year-old male patient.
• Initial diagnosis of meningitis via cerebrospinal fluid culture.
• Subsequent diagnosis of infected abdominal aortic aneurysm using CT scans and PCR for Streptococcus pneumoniae lytA gene.

Main Results:

• Patient initially presented with meningitis, successfully treated with antibiotics.
• Developed an infected abdominal aortic aneurysm with rapid expansion.
• Polymerase chain reaction detected Streptococcus pneumoniae DNA in the aortic wall despite negative blood and tissue cultures.
• Successful surgical resection and reconstruction with antibiotic-soaked prosthesis.

Conclusions:

• Molecular diagnostic techniques like PCR can rapidly detect pathogens in cases of suspected infected aneurysms, even with negative cultures.
• Prompt and accurate diagnosis is essential for effective management and postoperative antibiotic selection.
• This case underscores the potential for serious vascular complications following pneumococcal meningitis.