Acute expansion of a hospital-acquired methicillin-resistant Staphylococcus aureus-infected abdominal aortic aneurysm.
Infected aortic aneurysms (IAAs) are rare but can have devastating outcomes, particularly if diagnosis and treatment are delayed. The incidence of IAA is between 0.65% and 2% of all aortic aneurysms. The disease has a poor prognosis because these aneurysms have an increased tendency to grow rapidly and to rupture, and patients often have severe comorbidities and coexisting sepsis. Typical microorganisms associated with IAA are Salmonella, Streptococci, and Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus (MRSA) continues to emerge as a cause of serious infections, but its association with IAA is extremely rare. We present a rare case of infected abdominal aortic aneurysm caused by hospital-acquired (HA) MRSA. This case adds another presentation to the clinical spectrum of HA MRSA infections, and it highlights the problems encountered in the choice of the therapy of serious HA or health care-acquired infections in an era of increasing MRSA infections. We will discuss the clinical spectrum of HA MRSA infections as well as the problems encountered in the management of IAA, and will review the relevant literature.
Department of Surgery, VA Boston HCS, West Roxbury, MA 02132, USA.
Ossama M
OM
Reslan
James L
JL
Ebaugh
Naren
N
Gupta
Stephen M
SM
Brecher
Kamal M F
KM
Itani
Joseph D
JD
Raffetto
D000208:Acute Disease; D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D001027:Aortography / Q000379:methods; D001344:Autopsy; D019917:Blood Vessel Prosthesis Implantation; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents