Mycotic aneurysm of the descending thoracic aorta caused by Pseudomonas aeruginosa in a solid organ transplant recipient: case report and review

Surg Infect (Larchmt). 2002 Spring;3(1):29-33. doi: 10.1089/109629602753681131.

Abstract

Background: Pseudomonas aeruginosa is a rare cause of aortic mycotic aneurysms. Optimal treatment, including reconstructive graft material and appropriate length of antibiotic therapy, is being debated.

Methods: We describe a 26-year-old kidney-pancreas recipient who developed an aneurysm of the descending thoracic aorta caused by P. aeruginosa.

Results: After surgical debridement and cryopreserved allograft reconstruction, parenteral antibiotics were continued for 12 months, at which time the patient was converted to oral antibiotic therapy. Within 6 months, he redeveloped a thoracic aortic aneurysm, necessitating reoperation and lifelong parenteral antibiotic therapy.

Conclusion: Herein we review and discuss the relevant literature concerning surgical and antibiotic treatment of mycotic thoracic aneurysms.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aneurysm, Infected / therapy*
  • Aortic Aneurysm, Thoracic / therapy*
  • Aztreonam / administration & dosage*
  • Blood Vessel Prosthesis Implantation
  • Debridement
  • Drug Therapy, Combination / administration & dosage*
  • Humans
  • Infusions, Parenteral / methods
  • Male
  • Organ Transplantation*
  • Penicillanic Acid / administration & dosage*
  • Penicillanic Acid / analogs & derivatives
  • Piperacillin / administration & dosage*
  • Piperacillin, Tazobactam Drug Combination
  • Pseudomonas Infections / therapy*
  • Secondary Prevention
  • Treatment Outcome
  • Vancomycin / administration & dosage*

Substances

  • Piperacillin, Tazobactam Drug Combination
  • Vancomycin
  • Penicillanic Acid
  • Aztreonam
  • Piperacillin