Mycotic aortic pseudoaneurysm with aortoenteric fistula caused by Arizona hinshawii

A case of bacteremic infection of a nonaneurysmal atherosclerotic infrarenal abdominal aorta by Arizona hinshawii that resulted in formation of a false aneurysm and secondary aortoduodenal fistula is reported and analyzed. Patients with bacteremia, gastroenteritis, or localized infectious processes due to Arizona species should be considered at risk for possible secondary arterial infection from transient bacteremia. In addition, patients over 50 years of age with atherosclerosis or patients with previously implanted cardiac and/or vascular prostheses who develop bacteremia or gastroenteritis because of Arizona species may be candidates for aggressive treatment with antimicrobial agents. The late diagnosis of primary arterial infections is associated with a high mortality rate, and an aggressive surgical posture is clearly indicated. Antimicrobial management should be instituted promptly in conjunction with, not in place of, aggressive surgical therapy.