A patient with a ruptured abdominal aortic aneurysm with clostridial infection was successfully managed by oversewing the aorta, debridement, and axillobifemoral bypass. Infected aneurysms of the abdominal aorta may present a confusing clinical picture, causing a delay in correct diagnosis. A history of fever and a palpable aneurysm should suggest the diagnosis. In obese individuals, abdominal roentgenograms and sonography may be helpful in establishing the presence of an aneurysm. Aortography may support the diagnosis of infection by the presence of a lobulated saccular aneurysm. Occasionally, the operative appearance of the aorta may be the only indica tion of an infected aortic aneurysm. The decision to oversew the aorta and perform an extra-anatomic bypass as the initial surgical procedure is essential for the proper management of these patients.
Hardy, J.D., Timmis, H.H.: Abdominal aortic aneurysm: Special problems. Ann. Surg., 173: 945, 1971.
7.
Hyde, G.L., Hull, D.A., Stoeckinger, J.M.: Ruptured mycotic aneurysms of the abdominal aorta. J. Ky. Med. Assoc.,71: 728, 1973.
8.
Lewis, J.F., Warshaver, S.E.: Mycotic aneurysm of the abdominal aorta. South. Med. J., 62: 597, 1969.
9.
Mendelowitz, D.S., Ramstedt, R., Yao, J.S.T., et al.: Abdominal aortic salmonellosis . Surgery, 85: 514, 1979.
10.
Mundth, E.D. , Darling, R.C., Aluarado, R.H., et al.: Surgical management of mycotic aneurysms and the complications of infection in vascular reconstructive surgery . Am. J. Surg., 117: 460, 1969.
11.
Ohma, K.: Mycotic aneurysm due to Salmonella infection with perforation to the duodenum. Nord. Med., 73: 10, 1965.
12.
Reichle, F.A. , Tyson, R.R., Soloff, L.A., et al.: Salmonellosis and aneurysm of the distal abdominal aorta. Case report with review. Ann. Surg. , 171: 219, 1970.
Zak, F.G., Strauss, L., Saphra, I.: Rupture of diseased large arteries in the course of enterobacterial (Salmonella) infection. N. Engl. J. Med.,258: 824, 1958 .
15.
Cooke, P.A. , Ehrenfeld, W.K.: Successful management of mycotic aortic aneurysm: Report of a case. Surgery, 75: 132, 1974.
16.
Scher, L.A., Brener, B.J., Goldenkranz, R.J., et al.: Infected aneurysms of the abdominal aorta. Arch. Surg., 115: 975, 1980.
Jarrett, F. , Darling, R.C., Mundth, E.D., et al.: Experience with infected aneurysms of the abdominal aorta. Arch. Surg., 110: 1281, 1975 .
20.
Collins, G.J. , Jr., Rich, N.M., Hobson, R.W., II, et al.: Multiple mycotic aneurysms due to candida endocarditis. Ann. Surg.,186: 136, 1977 .
21.
Hyde, R.D., Davis, P.K.B.: Infection of an aortic aneurysm with Salmonella cholerasuis. Br. Med. J., 1: 30, 1962.
22.
Sower, N.D. , Whelan, T.J.: Suppurative arteritis due to Salmonella . Surgery, 52: 851, 1962.
23.
Thomson, W.H.G. : Infected aneurysm of abdominal aorta: Successful resection and prosthetic replacement. Proc. R. Soc. Med.60: 475, 1967.
24.
Austin, D.J. , Thompson, J.E., Patman, R.D., et al.: Infected arteriosclerotic aneurysm of the abdominal aorta. Am. J. Surg., 118: 950, 1969 .
25.
Meade, R.H. , III, Moran, J.M.: Salmonella arteritis—preoperative diagnosis and cure of Salmonella typhimurium aortic aneurysm. N. Engl. J. Med.,281: 310, 1969.
26.
Bob, H.B., Glassman, C.I.: Management of mycotic aneurysm abdominal aorta. Del. Med. J., 46: 561, 1974.
27.
Finseth, F. , Abbott, W.M.: One-stage operative therapy for Salmonella mycotic abdominal aortic aneurysm. Ann. Surg., 179: 8, 1974.
