Page 11 - Virtual Vascular Vol 10
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Mycotic Infrarenal Pseudoaneurysm
75-year-old gentleman presented with on and off fever for two weeks. Subsequent CT scan high index of suspicion is essential. In a patient with Salmonella bacteraemia who has sugges-
A showed a saccular outpouching (Figures 1 and 2, Arrow) over the infrarenal abdominal aorta A tive symptoms such as abdominal pain/back pain, a CT scan should be performed to rule out
with surrounding periaortic stranding suggestive of a mycotic aneurysm. The cultures upon ad- the possibility of a mycotic aneurysm. This patient was stabilized with broad spectrum antibiotics,
mission have all been negative, though this may be related to his prior antibiotic treatment in the followed by repair using endovascular stent graft. Figure 3a is the intraoperative angiogram show-
private sector. Mycotic aortic aneurysm is a disease with significant mortality and morbidity. The ing the typical outpouching of a pseudoaneurysm. Figure 3b showed the complete exclusion of
risk factors include atherosclerotic aorta as well as diabetes mellitus. The commonest microbes the pseudoaneurysm by the stent graft.
responsible are Staphylococcus as well as Salmonella. In particular, Salmonella has the propensity
to infect the aorta causing a mycotic aneurysm.
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