A Case of Infective Abdominal Aortic Aneurysm due to Haemophilus influenzae Type B

Abstract

Infective abdominal aortic aneurysm (IAAA) is relatively rare, but a case which is caused by Haemophilus influenzae type B is very rare. We experienced one IAAA case due to H. influenzae type B. The patient was 69-year-old man presenting with severe abdominal and back pain and elevated C-reactive protein (CRP), as inflammatory marker. The patient was found to have saccular aneurysm infrarenal aorta on computed tomography scanning. First, we started to treat him with antibiotic agent and second, we operated him at day 8 after admission with expanded polytetrafluoroethylene graft. Revascularization was made in situ reconstruction. As the result of culture with aneurysm wall, we found that the cause of this aneurysm was the infection of H. influenzae type B. As far as we know, this bacterium is scarcely reported as the cause of infective aortic aneurysms. We reported this IAAA case with the review of the English literature.

Keywords

abdominal aortic aneurysm - infection - mycotic aneurysm - polytetrafluoroethylene - C-reactive protein - in situ reconstruction - false aneurysm

• References

• 1 Reddy DJ, Shepard AD, Evans JR, Wright DJ, Smith RF, Ernst CB. Management of infected aortoiliac aneurysms. Arch Surg 1991; 126 (7) 873-878 , discussion 878–879
• 2 Bandyk DF. Vascular infections. In: Greenfield LJ, ed. Surgery: Scientific Principles and Practice. 1st ed. Philadelphia: J.B. Lippincott; 1993: 1568-1579
• 3 Sörelius K, Mani K, Björck M, Nyman R, Wanhainen A. Endovascular repair of mycotic aortic aneurysms. J Vasc Surg 2009; 50 (2) 269-274
• 4 Razavi MK, Razavi MD. Stent-graft treatment of mycotic aneurysms: a review of the current literature. J Vasc Interv Radiol 2008; 19 (6, Suppl) S51-S56
• 5 Ohta T. Infected aneurysms. Intern Med 2000; 39 (11) 875-876
• 6 Moore WS, Malone JM. Mycotic aneurysms. In: Yao JST, Pearce WH, eds. Aneurysms: New Findings and Treatment. Norwalk, Connecticut: Appleton and Lange; 1994: 389-410
• 7 Whitfield CG, Lonsdale RJ, Rahbour G, Parsons H, Dodd PD. Infective abdominal aortic aneurysm due to Haemophilus influenza identified via the polymerase chain reaction. Eur J Vasc Endovasc Surg 2008; 36 (1) 28-30
• 8 Degener JE, Voesten HG, Nap M, Roukema J. Rupture of an aortic aneurysm caused by Haemophilus influenzae type B infection. Vasa 1993; 22 (3) 247-250
• 9 Adlakha A, Yale SH, Patel R, Edson RS, Schultz HJ, Stanson AW. Haemophilus influenzae serotype f: an unusual cause of a mycotic aneurysm in an adult. Mayo Clin Proc 1994; 69 (5) 467-468
• 10 Yamazaki S, Boku K, Ueki Y , et al. A case of infectious abdominal aortic aneurysm complicated with septicaemia caused by Haemophilus influenza. J Jap Soc Int Med 1999; 88: 342-343 [Japanese]
• 11 Byrne G, Barber P, Farrington M. Aortitis caused by β-lactamase producing Haemophilus influenzae type b. J Clin Pathol 1989; 42 (4) 438-439
• 12 Woon CYL, Sebastian MG, Tay KH, Tan SG. Extra-anatomic revascularization and aortic exclusion for mycotic aneurysms of the infrarenal aorta and iliac arteries in an Asian population. Am J Surg 2008; 195 (1) 66-72
• 13 Müller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg 2001; 33 (1) 106-113
• 14 Canaud L, Marzelle J, Bassinet L, Carrié AS, Desgranges P, Becquemin JP. Tuberculous aneurysms of the abdominal aorta. J Vasc Surg 2008; 48 (4) 1012-1016
• 15 Kan CD, Lee HL, Yang YJ. Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review. J Vasc Surg 2007; 46 (5) 906-912
• 16 Lee KH, Won JY, Lee Y , et al. Stent-graft treatment of infected aortic and arterial aneurysms. J Endovasc Ther 2006; 13 (3) 338-345
• 17 Sayed S, Choke E, Helme S , et al. Endovascular stent graft repair of mycotic aneurysms of the thoracic aorta. J Cardiovasc Surg (Torino) 2005; 46 (2) 155-161
• 18 Van Doorn RC, Reekers J, de Mol BA, Obertop H, Balm R. Aorto-esophageal fistula secondary to mycotic thoracic aortic aneurysm: endovascular repair and transhiatal esophagectomy. J Endovasc Ther 2002; 9 (2) 212-217