Mycotic aneurysm of the thoracic aorta caused by extended-spectrum beta-lactamase-producing Escherichia coli

Interact Cardiovasc Thorac Surg. 2011 Jan;12(1):61-2. doi: 10.1510/icvts.2010.249102. Epub 2010 Oct 22.

Abstract

We report a case of successful treatment of a mycotic aneurysm of the thoracic aorta. A 65-year-old man with a dissecting aneurysm presented with urinary tract infection. He had a history of severe liver cirrhosis. Two weeks after admission, he had a high-grade fever and enhanced computed tomography (CT) demonstrated acute expansion of the distal aortic arch aneurysm. Because of the acute aneurysm expansion and elevated inflammatory response, we suspected a mycotic aortic aneurysm with possible impending rupture. Since conventional open chest surgery was considered to carry a high operative risk, the patient was managed with a combination of emergency endovascular treatment and antibiotic chemotherapy. Extended-spectrum beta-lactamase-producing Escherichia coli were identified from blood culture before treatment. After strict antibiotic therapy, the postoperative course was uneventful and the patient remained well 12 months later.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, Dissecting / diagnostic imaging
  • Aneurysm, Dissecting / microbiology*
  • Aneurysm, Dissecting / therapy
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / microbiology*
  • Aneurysm, Infected / therapy
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / microbiology*
  • Aortic Aneurysm, Thoracic / therapy
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation
  • Combined Modality Therapy
  • Endovascular Procedures
  • Escherichia coli / enzymology*
  • Humans
  • Male
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases