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Mycotic aneurysm by Bacteroides fragilis presenting as fever of unknown origin

Mani Bhushan Kumar1, Lokesh Varada1, Kishore Abuji2

  • 1Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Indian Journal of Medical Microbiology
|March 4, 2023
PubMed

Insights

Mycotic aneurysms, infections of the vessel wall, are fatal if untreated. This case highlights successful treatment of an abdominal aortic aneurysm caused by Bacteroides fragilis.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Mycotic aneurysms result from microbial infection of the arterial wall, often leading to severe complications.
  • Prompt diagnosis and treatment are crucial as these aneurysms are frequently fatal without intervention.
  • Bacterial infections are a common cause, necessitating accurate pathogen identification for targeted therapy.

Observation:

  • A 46-year-old male presented with high-grade fever and progressive lower back pain.
  • CT angiography revealed an infrarenal lobulated abdominal aortic aneurysm.
  • The patient's condition worsened over the course of the illness.

Findings:

  • Culture reports identified Bacteroides fragilis as the causative agent.
  • The patient underwent successful aneurysmorrhaphy (surgical repair of the aneurysm).
  • Post-operative treatment included metronidazole, an antibiotic effective against Bacteroides fragilis.

Implications:

  • This case demonstrates the successful management of a potentially fatal mycotic abdominal aortic aneurysm.
  • Early detection and appropriate antibiotic therapy are key to favorable outcomes.
  • Effective surgical intervention combined with targeted antimicrobial treatment can lead to patient recovery.
Keywords:
AnaerobicBacteroides fragilisMycotic aneurysm

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