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Dialister pneumosintes and aortic graft infection - a case report
Rachel Patel1,2, Debra S T Chong3, Alison J Guy3
1Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK. rachelsarahpatel@gmail.com.
Background:
Dialister pneumosintes is an anaerobic, Gram negative bacillus, found in the human oral cavity and associated with periodontitis. It has also been isolated from gastric mucosa and stool samples. Recent case reports implicate D. pneumosintes in local infection such as dental root canals, sinusitis, Lemierres syndrome and brain abscesses, as well as distal infections of the liver and lung through haematogenous spread.
Case Presentation:
We present a novel case of aortic graft infection and aortoenteric fistula (AEF) in a 75 year old Caucasian male, associated with D. pneumosintes bacteraemia. Microbiological evaluation of septic emboli in the lower limbs revealed other gastrointestinal flora. This suggests either AEF leading to graft infection and subsequent distal emboli and bacteraemia, or a dental origin of infection which seeded to the graft, resulting in AEF and systemic infection. To our knowledge this is the first report of D. pneumosintes associated aortic graft infection. The patient underwent surgical explantation, oversew of the aorta and placement of extra-anatomical bypass graft in conjunction with antimicrobial therapy, making a good recovery with discharge home after a 35-day hospital admission.
Conclusion:
We report a case of Dialister pneumosintes bacteraemia associated with aortic graft infection. To our knowledge, vascular graft-associated infection with D. pneumosintes has not been reported before.
Insights
This study reports the first case of Dialister pneumosintes causing aortic graft infection and aortoenteric fistula. Successful treatment involved surgery and antibiotics, highlighting a new potential complication of this oral bacterium.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Microbiology
Background:
- Dialister pneumosintes is an anaerobic, Gram-negative bacillus found in the human oral cavity, linked to periodontitis.
- This bacterium has been implicated in various local infections, including dental abscesses and sinusitis, and can spread to distant organs.
Observation:
- A 75-year-old male presented with an aortic graft infection and aortoenteric fistula (AEF).
- Blood cultures and septic emboli revealed Dialister pneumosintes bacteraemia, alongside other gastrointestinal flora.
Findings:
- This is the first reported case of Dialister pneumosintes associated with aortic graft infection and AEF.
- The infection may have originated from the gastrointestinal tract or a dental source, seeding the aortic graft.
Implications:
- This case expands the spectrum of known Dialister pneumosintes infections to include vascular graft complications.
- Early recognition and appropriate surgical and antimicrobial management are crucial for treating such rare infections.
