Infected thoracic aortic aneurysm caused by Clostridium ramosum: A case report

A 73-year-old man undergoing conservative management of acute aortic dissection (Stanford type B) was diagnosed with infected aortic aneurysm based on clinical findings of aortic dilatation and recurrent laryngeal nerve paralysis. We performed total aortic arch replacement with a synthetic graft and omentopexy; and Clostridium ramosum was isolated from resection specimens. Infected aortic aneurysms are rare but may lead to death from aortic dissection or rupture. C. ramosum infection is rare and has seldom been reported, and thus no treatment guidelines, including antibiotic therapy, have been established. Therefore, it is necessary to accumulate a larger number of cases of aortic aneurysm infected by C. ramosum. To date, there has been no reported case of infected aortic aneurysm due to C. ramosum. Here, we report a case of infected aortic aneurysm due to C. ramosum. <Learning objective: Infected aortic aneurysm is a life-threatening condition because of the possibility of aortic dissection and rupture. Infected aortic aneurysms are often caused by Staphylococcus aureus and Salmonella species, and there has been no report of aortic aneurysm infected by C. ramosum. Regarded as a non-pathogenic intestinal bacterium, C. ramosum is seldom identified as a causative bacterium. In this case, dilatation of aorta progressed rapidly, requiring early surgical treatment.>.