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Open treatment of infected abdominal aortic aneurysm stemming from perineal infection

Andrew Hendrix1, Ankur Makani2, Thomas Crafton2

  • 1University of South Carolina School of Medicine, 6311 Garners Ferry Rd, Columbia, SC 29209, United States.

Journal of Surgical Case Reports
|August 9, 2024
PubMed

Insights

Infected abdominal aortic aneurysms (AAAs) are rare but deadly. A case shows Proteus mirabilis bacteremia rapidly growing a stable AAA, emphasizing prompt diagnosis and surgical intervention for infected aortic aneurysms.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Aortic Aneurysm Management

Background:

  • Infected abdominal aortic aneurysms (IAAs) represent a small fraction of abdominal aortic aneurysms (AAAs) but carry a significantly higher mortality rate due to increased rupture risk.
  • Prompt diagnosis and effective management are crucial for improving outcomes in patients with IAAs.

Observation:

  • A 56-year-old male presented with Proteus mirabilis bacteremia originating from a perineal abscess.
  • This patient had a previously stable 3 cm abdominal aortic aneurysm (AAA).
  • The AAA demonstrated rapid growth over an 8-day period following the onset of bacteremia.

Findings:

  • The case highlights a rare instance of rapid AAA expansion secondary to bacteremia.
  • Proteus mirabilis bacteremia was identified as the likely trigger for the aneurysm's accelerated growth.
  • Surgical intervention was critical for achieving source control in this complex case.

Implications:

  • Clinicians should maintain a high index of suspicion for infected aortic aneurysms in critically ill patients, especially those with bacteremia.
  • Early recognition and aggressive surgical management, including source control, are paramount in managing infected aortic aneurysms.
  • This case emphasizes the potential for rapid AAA progression in the setting of systemic infection.
Keywords:
abdominal aortic aneurysmmycotic aneurysmopen repairvascular surgery

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