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Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint
BACKGROUND: Endograft infection is a rare but extremely dangerous complication of aortic repair (25–100% of mortality). We describe here the first case of Listeria monocytogenes abdominal periaortitis associated with a vascular graft. We also discuss the differential diagnosis of periaortitis and pr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469050/ https://www.ncbi.nlm.nih.gov/pubmed/30991963 http://dx.doi.org/10.1186/s12879-019-3953-z |
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author | Foulex, Aurélie Coen, Matteo Cherkaoui, Abdessalam Lazarevic, Vladimir Gaïa, Nadia Leo, Stefano Girard, Myriam Mugnai, Damiano Schrenzel, Jacques |
author_facet | Foulex, Aurélie Coen, Matteo Cherkaoui, Abdessalam Lazarevic, Vladimir Gaïa, Nadia Leo, Stefano Girard, Myriam Mugnai, Damiano Schrenzel, Jacques |
author_sort | Foulex, Aurélie |
collection | PubMed |
description | BACKGROUND: Endograft infection is a rare but extremely dangerous complication of aortic repair (25–100% of mortality). We describe here the first case of Listeria monocytogenes abdominal periaortitis associated with a vascular graft. We also discuss the differential diagnosis of periaortitis and provide a literature review of L. monocytogenes infectious aortitis. CASE PRESENTATION: Nine months after endovascular treatment of an abdominal aortic aneurysm (abdominal stent graft), a 76-year-old man was admitted for severe abdominal pain radiating to the back. Laboratory tests were normal apart from elevated C-reactive protein (CRP). Injected abdominal computed tomography (CT) showed infiltration of the fat tissues around the aortic endoprosthesis and aneurysmal sac expansion; positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) showed a hypermetabolic mass in contact with the endoprosthesis. Blood cultures were negative. At surgical revision, an infra-renal peri-aortic abscess was evident; post-operative antibiotic therapy with ciprofloxacin and doxycycline was started. Cultures of intraoperative samples were positive for L. monocytogenes. Results were further confirmed by a broad-range polymerase chain reaction (PCR) and next-generation sequencing. Antibiotic treatment was switched to intravenous amoxicillin for 6 weeks. Evolution was uneventful with decrease of inflammatory parameters and regression of the abscess. CONCLUSION: An etiologic bacterial diagnosis before starting antibiotic therapy is paramount; nevertheless, culture-independent methods may provide a microbiological diagnosis in those cases where antimicrobials are empirically used and when cultures remain negative. |
format | Online Article Text |
id | pubmed-6469050 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64690502019-04-23 Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint Foulex, Aurélie Coen, Matteo Cherkaoui, Abdessalam Lazarevic, Vladimir Gaïa, Nadia Leo, Stefano Girard, Myriam Mugnai, Damiano Schrenzel, Jacques BMC Infect Dis Case Report BACKGROUND: Endograft infection is a rare but extremely dangerous complication of aortic repair (25–100% of mortality). We describe here the first case of Listeria monocytogenes abdominal periaortitis associated with a vascular graft. We also discuss the differential diagnosis of periaortitis and provide a literature review of L. monocytogenes infectious aortitis. CASE PRESENTATION: Nine months after endovascular treatment of an abdominal aortic aneurysm (abdominal stent graft), a 76-year-old man was admitted for severe abdominal pain radiating to the back. Laboratory tests were normal apart from elevated C-reactive protein (CRP). Injected abdominal computed tomography (CT) showed infiltration of the fat tissues around the aortic endoprosthesis and aneurysmal sac expansion; positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) showed a hypermetabolic mass in contact with the endoprosthesis. Blood cultures were negative. At surgical revision, an infra-renal peri-aortic abscess was evident; post-operative antibiotic therapy with ciprofloxacin and doxycycline was started. Cultures of intraoperative samples were positive for L. monocytogenes. Results were further confirmed by a broad-range polymerase chain reaction (PCR) and next-generation sequencing. Antibiotic treatment was switched to intravenous amoxicillin for 6 weeks. Evolution was uneventful with decrease of inflammatory parameters and regression of the abscess. CONCLUSION: An etiologic bacterial diagnosis before starting antibiotic therapy is paramount; nevertheless, culture-independent methods may provide a microbiological diagnosis in those cases where antimicrobials are empirically used and when cultures remain negative. BioMed Central 2019-04-16 /pmc/articles/PMC6469050/ /pubmed/30991963 http://dx.doi.org/10.1186/s12879-019-3953-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Foulex, Aurélie Coen, Matteo Cherkaoui, Abdessalam Lazarevic, Vladimir Gaïa, Nadia Leo, Stefano Girard, Myriam Mugnai, Damiano Schrenzel, Jacques Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title | Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title_full | Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title_fullStr | Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title_full_unstemmed | Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title_short | Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
title_sort | listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469050/ https://www.ncbi.nlm.nih.gov/pubmed/30991963 http://dx.doi.org/10.1186/s12879-019-3953-z |
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