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Abdominal aorta aneurysm endograft infection mimicking bacteraemic urinary tract infection

N Papazoglou1, M Samarkos1, C Vergadis2

  • 11st Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.

Hippokratia
|August 8, 2022
PubMed
Abstract

Insights

Endograft infections after endovascular aneurysm repair can be successfully treated with percutaneous drainage and long-term antibiotics, avoiding major surgery. This approach offers a viable alternative for high-risk patients, preventing infection recurrence.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases

Background:

  • Endograft infection is a rare but serious complication of endovascular aneurysm repair (EVAR).
  • Symptoms often include abdominal pain, fever, fatigue, and gastrointestinal bleeding, but diagnosis can be challenging.
  • Standard treatment typically involves antibiotics, surgical debridement, and revascularization.

Observation:

  • A 75-year-old male presented with fever, initially misdiagnosed as a urinary tract infection.
  • The patient had a confirmed endovascular graft infection.
  • Due to high surgical risk, a conservative approach was chosen.

Findings:

  • Percutaneous drainage of the aortic sac abscess was performed.
  • The patient received three weeks of intravenous antibiotics followed by two months of oral antibiotics.
  • At six-month follow-up, there were no signs of infection recurrence.

Implications:

  • This case demonstrates a successful alternative management strategy for endograft infections in high-risk patients.
  • Percutaneous drainage combined with prolonged antibiotic therapy can be effective.
  • A high index of suspicion is essential for timely diagnosis and treatment of endovascular graft infections.
Keywords:
Prosthesis-related infectionsSerratia marcescensabdominal aorta aneurysmbacteremiavascular grafting

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