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Mycotic aneurysm with recurrent sepsis complicating post-transplant nephrectomy
The Johns Hopkins Medical Journal
|August 1, 1977
Summary
A patient undergoing renal transplantation developed a mycotic aneurysm, a serious infection of the artery. This complication led to sudden death due to rupture, highlighting the need for vigilance in transplant patients.
Area of Science:
- Nephrology
- Vascular Surgery
- Infectious Diseases
Background:
- A 37-year-old hypertensive male received a renal transplant, complicated by recurrent Pseudomonas aeruginosa bacteremia.
- The transplanted kidney was removed postoperatively, and the patient required hemodialysis.
Observation:
- The patient presented with symptoms of acute peritoneal irritation and hypovolemia.
- Sudden death occurred following these acute symptoms.
Findings:
- Postmortem examination revealed a ruptured saccular mycotic aneurysm of the left common iliac artery.
- The aneurysm was located at the site of the post-transplant nephrectomy.
Implications:
- This case highlights postoperative mycotic aneurysms as a rare but fatal complication in renal transplant recipients.
- It underscores the often-obscure presentation of iliac artery aneurysms and the critical need for a high index of suspicion in this patient population.