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A ruptured mycotic aortic aneurysm in a patient with urinary retention: A case report

Samantha L Gaetani1, Jerome C Deutsch1, Mila H Ju2

  • 1Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida, Morsani College of Medicine; Cedar Crest Boulevard & I-78, Allentown, PA, 18103, USA.

Radiology Case Reports
|March 7, 2022
PubMed

Insights

A symptomatic abdominal aortic aneurysm (AAA) is a medical emergency. This case highlights a rapidly expanding AAA in a patient with COVID-19, emphasizing broader diagnostic considerations.

Area of Science:

  • Vascular Surgery
  • Infectious Disease
  • Emergency Medicine

Background:

  • Abdominal aortic aneurysms (AAAs) are often asymptomatic until rupture, posing a diagnostic challenge.
  • Ruptured AAAs have catastrophic patient outcomes, necessitating prompt recognition and intervention.
  • Symptomatic presentation of AAA requires urgent evaluation and management.

Observation:

  • A 55-year-old male presented with urinary retention and suprapubic pain.
  • Computed tomography revealed a rapidly expanding AAA with signs of impending rupture.
  • Concerns for a mycotic aneurysm were raised due to recent COVID-19 infection and possible bacteremia.

Findings:

  • Emergent vascular surgical repair was successfully performed for the rapidly expanding AAA.
  • The case underscores the importance of considering AAA in patients with concerning symptoms, even with other potential diagnoses.
  • Potential complications of COVID-19 infection, including mycotic aneurysms, warrant consideration.

Implications:

  • Clinicians must maintain a broad differential diagnosis and avoid diagnostic biases like anchoring.
  • This case highlights a rare but serious potential complication of COVID-19 infection.
  • Prompt surgical intervention is critical for managing symptomatic and ruptured abdominal aortic aneurysms.
Keywords:
Abdominal aortic aneurysmBacteremiaCOVID-19 infectionUrinary retention

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