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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.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|December 5, 2020
PubMed

Insights

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.
Keywords:
Group A streptococci (GAS)Infected aneurysmStreptococcus pyogenes

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