Long-term Successful Antibiotic Therapy for Recurrent Aortic Graft Infection

OBJECTIVE: To report a case of successful long-term conservative management of a patient with aortic graft infection due to multiple infectious agents. MATERIALS AND METHODS: We describe the clinical case and present a review of relevant literature. RESULTS: An 82-year-old man presented with recurrent Escherichia coli bacteraemia. He was diagnosed with an endovascular aortic graft infection. As the patient declined surgery, conservative treatment with daily antibiotic therapy was instituted. We report good clinical results after almost 2 years of treatment and follow-up. CONCLUSIONS: The preferred treatment of aortic graft infections is surgical. Conservative management is usually offered to poor surgical candidates and is associated with an unfavourable outcome. However, we report that selected patients may be successfully treated using prolonged antibiotic therapy. LEARNING POINTS: Endovascular graft infection is a serious, potentially life-threatening complication of aortic aneurism repair. Surgical management is the preferred therapeutic approach; information about conservative therapy options and their outcomes is limited. Long-term conservative management with ambulatory maintenance antibiotic therapy is an adequate treatment alternative and in selected patients can lead to a good clinical outcome.