Successful endovascular repair of a chronic Q fever-associated abdominal aortic infected aneurysm

Mycotic abdominal aortic aneurysm caused by Coxiella burnetii infection is rare and can be difficult to diagnose. The use of endovascular repair in mycotic abdominal aortic aneurysms is a controversial topic and its use to treat aneurysms specific to Coxeilla infection was rarely reported. We report a case of a 63-year-old man who had a suspicious travel and contact history and presented with persistent lumbar pain for more than 1 year without a proper diagnosis. Imaging revealed a large saccular infrarenal aortic aneurysm with surrounding stranding, L3 vertebral osteomyelitis, and psoas inflammation. The diagnosis of chronic C burnetii infection was confirmed by serological tests. Endovascular repair was performed successfully. Long-term antibiotics with doxycycline and hydroxychloroquine was prescribed. The patient was well for more than 3 years after surgery. Surveillance computed tomography scan showed shrinkage of aneurysm with no endoleak. There was no evidence of stent graft infection.