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Infected aortic aneurysm caused by Streptococcus pyogenes: A case report.
Noriyuki Watanabe1, Sachie Koyama1, Mayu Tabira1
1Clinical Laboratory, Saitama Medical University International Medical Center, Saitama, Japan.
Summary
This case report highlights a rare instance of an infected abdominal aortic aneurysm (AAA) caused by Streptococcus pyogenes. Prompt diagnosis and surgical intervention were crucial for managing this life-threatening condition.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Microbiology
Background:
- Infected abdominal aortic aneurysms (AAA) are uncommon but serious conditions.
- Streptococcus (S.) pyogenes is a rare causative agent of AAA.
Observation:
- A 77-year-old male with uncontrolled diabetes mellitus presented with fever and abdominal pain.
- Computed tomography revealed an abdominal aortic aneurysm with a false lumen.
- Elevated inflammatory biomarkers indicated a suspected infection.
Findings:
- S. pyogenes was identified as the causative agent from blood and tissue cultures using Matrix Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry.
- The patient underwent successful surgical aortic replacement and debridement.
- Antibiotic therapy was initiated with meropenem and daptomycin, later de-escalated to ampicillin based on susceptibility.
Implications:
- This case underscores the importance of considering S. pyogenes in the etiology of infected AAA, despite its rarity.
- Early diagnosis and appropriate antimicrobial and surgical management are critical for favorable outcomes.
- The findings contribute to the understanding of rare infectious complications of aortic aneurysms.
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