Abstract
Mycotic aortic aneurysm continues to present challenging and difficult management issues with a significant morbidity and mortality. The offending organism in the etiology of this aneurysm can be variable and unusual. The first report of two mycotic aortic aneurysms caused by Clostridium septicum in the same patient is described here. Presentation and management as well as conditions commonly associated with Clostridium septicum infection and a review of all clostridial mycotic aortic aneurysms in the English literature are discussed.
Get full access to this article
View all access options for this article.
References
1.
Taylor
LM
Deitz
DM
McConnell
DB
Porter
JM
. Treatment of infected abdominal aortic aneurysms by extra-anatomic bypass, aneurysm excision and drainage . Am J Surg
1988 ; 155 : 655 –8 .
2.
O'Hara
P
Hertzer
N
Beuen
E
Krajewski
L
. Surgical management of infected abdominal aortic grafts: review of a 25 year experience . J Vasc Surg
1986 ; 3 : 725 –31 .
3.
Jarrett
F
Darling
RC
Mundth
ED
Austen
W
. Experience with infected aneurysm of the abdominal aorta . Arch Surg
1975 ; 110 : 1281 –5 .
4.
Atnip
RG
. Mycotic aneurysms of suprarenal abdominal aorta: prolonged survival after in situ aortic and visceral reconstruction . J Vasc Surg
1989 ; 10 : 635 –41 .
5.
Gomez
MN
Choyke
PL
Wallace
RB
. Infected aortic aneurysms: a changing entity . Ann Surg
1992 ; 215 : 435 –42 .
6.
Chan
FY
Crawford
ES
Coselli
JS
In situ prosthetic graft replacement for mycotic aneurysm of the aorta . Ann Thorac Surg
1989 ; 47 : 193 –203 .
7.
Hollier
LH
Money
SR
Creely
B
Direct replacement of mycotic thoracoabdominal aneurysm . J Vasc Surg
1993 ; 18 : 477 –84 .
8.
Brown
SL
Busutill
RW
Baker
JD
Bacteriologic and surgical determinants of survival in patients with mycotic aneurysms . J Vasc Surg
1984 ; 1 : 541 –7 .
9.
Gorbach
SC
Bartlett
JG
. Anaerobic infections . N Engl J Med
1974 ; 290 : 1177 .
10.
Nichols
GB
Schilling
PJ
. Pseudo-retroperitoneal gas in rupture of an aneurysm of abdominal aorta . Am J Roentgenol Rad Ther Nuclear Med
1975 ; 125 : 134 –7 .
11.
Babenco
GO
Joffe
N
Tischler
AS
Kasdan
E
. Gas forming clostridial mycotic aneurysm of the abdominal aorta . Angiology
1976 ; 27 : 602 –9 .
12.
Semel
L
Aikman
WO
Parker
FB
Nontraumatic clostridial myonecrosis and mycotic aneurysm formation . N Y State J Med
1984 ; 84 : 195 –6 .
13.
Brahan
RB
Kahler
RC
.
Clostridium septicum as a cause of pericarditis and mycotic aneurysm . J Clin Microbiol
1990 ; 28 : 2377 –8 .
14.
Skipper
D
Birch
HA
Fallowfield
ME
Taylor
RS
. Clostridial mycotic aneurysm of the suprarenal abdominal aorta . J Cardiovasc Surg (Torino)
1990 ; 32 : 472 –4 .
15.
Hurley
L
Howe
K
. Mycotic aortic aneurysm infected by Clostridium septicum - a case history . Angiology
1991 ; 41 : 585 –9 .
16.
Fichelle
JM
Tabet
G
Cormier
P
Infected infrarenal aortic aneurysms: when is in situ reconstruction safe?
J Vasc Surg
1993 ; 17 : 635 –45 .
17.
Jendrzejewski
JW
Jones
SR
Newcombe
RI
Gilbert
DN
. Nontraumatic clostridial myonecrosis . Am J Med
1978 ; 65 : 542 –6 .
18.
Koransky
JR
Stargel
MD
Dowell
VR
Jr
.
Clostridium septicum bacteremia. Its clinical significance . Am J Med
1979 ; 66 : 63 –6 .
19.
Gomez
MN
Choyke
PL
. Infected aortic aneurysms: CT diagnosis . J Cardiovasc Surg (Torino)
1992 ; 33 : 684 –9 .
20.
Bennett
DE
Cherry
JK
. Bacterial infection of aortic aneurysms: a clinicopathologic study . Am J Surg
1967 ; 11 : 321 –6 .
21.
Ewart
JM
Burke
ML
Bunt
TJ
. Spontaneous abdominal aortic infections: essentials of diagnosis and management . Ann Surg
1983 ; 49 : 37 –50 .
22.
Johansen
K
Devin
J
. Mycotic aneurysms. A reappraisal . Arch Surg
1983 ; 118 : 583 –8 .
23.
Hill
GB
Osterhout
S
. Experimental effects of hyperbaric oxygen on selected clostridial species, in vitro studies . J Infect Dis
1972 ; 125 : 26 –35 .
24.
Zak
FG
Strauss
L
Saphra
I
. Rupture of diseased large arteries in the course of enterobacterial (salmonella) infections . N Engl J Med
1958 ; 258 : 284 –8 .
25.
Hankins
JR
Yeager
GH
. Primary mycotic aneurysms . Surgery
1956 ; 40 : 747 –46 .
26.
Macbeth
GA
Rubin
JR
McIntyre
KE
The relevance of arterial wall microbiology to the treatment of prosthetic graft infections: graft infection vs. arterial infection . J Vasc Surg
1984 ; 1 : 750 –6 .
27.
McAuley
CE
Steed
DL
Webster
MW
, Bacterial presence in aortic thrombus at elective aneurysm resection: is it clinically significant?
Am J Surg
1984 ; 147 : 322 –4 .
28.
Trout
HH
Kozloff
L
Giordano
JM
. Priority of revascularization in patients with graft enteric fistulas, infected arteries, or infected arterial prostheses . Ann Surg
1984 ; 199 : 669 –81 .
