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Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report

INTRODUCTION: Coxiella burnetii, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a C. burnetii-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repai...

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Autores principales: Kloppenburg, Geoffrey TL, van de Pavoordt, Eric DWM, de Vries, Jean-Paul PM
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250966/
https://www.ncbi.nlm.nih.gov/pubmed/22145758
http://dx.doi.org/10.1186/1752-1947-5-565
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author Kloppenburg, Geoffrey TL
van de Pavoordt, Eric DWM
de Vries, Jean-Paul PM
author_facet Kloppenburg, Geoffrey TL
van de Pavoordt, Eric DWM
de Vries, Jean-Paul PM
author_sort Kloppenburg, Geoffrey TL
collection PubMed
description INTRODUCTION: Coxiella burnetii, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a C. burnetii-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repair. CASE PRESENTATION: A 62-year-old Caucasian man was admitted to our hospital three months after endovascular aortic aneurysm repair with a bifurcated stent graft. He had increasing abdominal complaints and general malaise. A computed tomography scan of his abdomen revealed several para-aneurysmal abscesses. Surgery was performed via midline laparotomy. The entire abdominal wall of his aneurysmal sac, including the abscesses, was removed. The vascular endoprosthesis showed no macroscopic signs of infection. The decision was made to leave the endograft in place because of the severe cardiopulmonary comorbidities, thereby avoiding suprarenal clamping and explantation of this device with venous reconstruction. The proximal and distal parts of the endograft were secured to the aortic wall and common iliac artery walls, respectively, to avoid future migration. Polymerase chain reaction for C. burnetii was positive in all specimens of aortic tissue. Specific antibiotic therapy was initiated. Our patient was discharged in good clinical condition after six days. CONCLUSIONS: In our patient, the infection was limited to the abdominal aneurysm wall, which was removed, leaving the endograft in place. Vascular surgeons should be familiar with this bailout procedure in high-risk patients.
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spelling pubmed-32509662012-01-05 Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report Kloppenburg, Geoffrey TL van de Pavoordt, Eric DWM de Vries, Jean-Paul PM J Med Case Reports Case Report INTRODUCTION: Coxiella burnetii, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a C. burnetii-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repair. CASE PRESENTATION: A 62-year-old Caucasian man was admitted to our hospital three months after endovascular aortic aneurysm repair with a bifurcated stent graft. He had increasing abdominal complaints and general malaise. A computed tomography scan of his abdomen revealed several para-aneurysmal abscesses. Surgery was performed via midline laparotomy. The entire abdominal wall of his aneurysmal sac, including the abscesses, was removed. The vascular endoprosthesis showed no macroscopic signs of infection. The decision was made to leave the endograft in place because of the severe cardiopulmonary comorbidities, thereby avoiding suprarenal clamping and explantation of this device with venous reconstruction. The proximal and distal parts of the endograft were secured to the aortic wall and common iliac artery walls, respectively, to avoid future migration. Polymerase chain reaction for C. burnetii was positive in all specimens of aortic tissue. Specific antibiotic therapy was initiated. Our patient was discharged in good clinical condition after six days. CONCLUSIONS: In our patient, the infection was limited to the abdominal aneurysm wall, which was removed, leaving the endograft in place. Vascular surgeons should be familiar with this bailout procedure in high-risk patients. BioMed Central 2011-12-06 /pmc/articles/PMC3250966/ /pubmed/22145758 http://dx.doi.org/10.1186/1752-1947-5-565 Text en Copyright ©2011 Kloppenburg et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kloppenburg, Geoffrey TL
van de Pavoordt, Eric DWM
de Vries, Jean-Paul PM
Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title_full Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title_fullStr Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title_full_unstemmed Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title_short Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report
title_sort endograft-preserving therapy of a patient with coxiella burnetii-infected abdominal aortic aneurysm: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250966/
https://www.ncbi.nlm.nih.gov/pubmed/22145758
http://dx.doi.org/10.1186/1752-1947-5-565
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