Periaortic endograft infection due to Listeria monocytogenes treated with graft preservation.
A 67-year-old man presented to our hospital with general malaise, fever and diffuse abdominal and lower back pain 7 weeks after endovascular aneurysm repair. Blood samples showed a leukocyte count of 10.9 x 10(9)/l and a C-reactive protein of 239 mg/l. The computed tomography (CT)-scan showed fluid collections behind the proximal part of the endovascular graft and dorsal to the aorta. CT-guided translumbar needle aspiration of these collections yielded growth with Listeria monocytogenes. Prosthetic endograft infection is an extremely rare event, especially when it is caused by L. monocytogenes. Given the scarcity of this complication, no consensus has been reached for its treatment. In the described case, radiological drainage and prolonged antibiotic treatment resulted in favourable outcome at midterm follow-up with preservation of the endograft.
Saleem
Ben R
BR
Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, Groningen, The Netherlands.
Berger
Paul
P
Zeebregts
Clark J
CJ
Slart
Riemer H
RH
Verhoeven
Eric L
EL
van den Dungen
Jan J
JJ
D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004322:Drainage; D006801:Humans; D008088:Listeriosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D049268:Positron-Emission Tomography; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D015662:Trimethoprim, Sulfamethoxazole Drug Combination