Mycotic Aneurysm of the Abdominal Aorta in a Patient Undergoing Hemodialysis: An Unusual Complication of Staphylococcus aureus Bacteremia

• Published in: Clinical infectious diseases Vol. 30; no. 5; pp. 823 - 824
• Main Authors: Lee, Chung-Ching, Ng, Yee-Yung, Chou, Yi-Hong, Tiu, Chui-Mei, Wang, Zing, Yang, Hui-Ming, Chen, Tzen-Wen, Yang, Wu-Chang
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.05.2000; University of Chicago Press
• Subjects: Abdominal aorta; Aged; Aneurysm, Infected - microbiology; Aneurysm, Ruptured - microbiology; Aneurysms; Antibiotics; Aortic Aneurysm, Abdominal - microbiology; Bacteremia; Bacteremia - complications; Bacteremia - microbiology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Blood; Brief Reports; Catheters; Diabetic angiopathies; Dialysis; Human bacterial diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Renal Dialysis; Salmonella; Staphylococcal Infections - complications; Staphylococcal Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Streptococcus; Human; Mycotic aneurysm; Hemodialysis; Cardiovascular disease; Bacteremia; Infection; Vascular disease; Abdominal aorta; Case study; Extrarenal dialysis; Bacteriosis; Bacteria; Micrococcales; Complication; Micrococcaceae; Staphylococcal infection; Aortic disease; Staphylococcus aureus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/313769

When Staphylococcus aureus is repeatedly positive in blood cultures even under effective antibiotics therapy (vancomycin, teicoplanin, or rifampin), computed tomography scan and sonography should be performed early to exclude mycotic aneurysm of the deeply seated arteries, especially in patients with abdominal aortic calcification. Before 1990, the most common causative organism of suprarenal aortic mycotic aneurysm was Salmonella; since 1990, it has been gram-positive cocci (i.e., Streptococcus and Staphylococcus) rather than gram-negative bacilli (i.e., Salmonella), possibly because of the more invasive procedures performed in clinical settings, but this hypothesis needs further investigation.