title: Mycotic aortic aneurysm caused by haemophilus influenzae group F.
abstract: BACKGROUND
  Haemophilus influenzae is a rare cause of mycotic aortic aneurysm. We present a case of H. influenzae mycotic aortic aneurysm, which was complicated by prior endovascular stent-graft placement at another facility.
  
  
  METHODS
  A 58 year-old man was treated by endograft placement for a presumed penetrating aortic ulcer after having symptoms of abdominal pain and malaise for one month. He presented to our institution 11 days after endograft placement with septic physiology. Repeat computed tomography angiogram demonstrated an inflammatory mass around the distal aorta and right common iliac artery, which had an associated contained rupture.
  
  
  RESULTS
  The patient was treated using intravenous antibiotics, axillo-bifemoral bypass followed by endograft explantation and aortic and iliac ligation. Intraoperative cultures grew Haemophilus influenzae, serotype f.
  
  
  CONCLUSIONS
  Aortic endografts have been successfully used for treatment of selected mycotic aneurysms, generally after adequate treatment of the primary infection with intravenous antibiotics. This case demonstrates the unfavorable natural history of endograft placement in an unsuspected mycotic aneurysm. A high index of suspicion for possible aortic infection should be maintained for patients with systemic symptoms and unusual aortic pathology prior to choosing endovascular repair.
authors.affiliation: Division of Vascular Surgery, University of Washington, Seattle, WA, USA.
authors.forename: Heather K
authors.initials: HK
authors.lastname: Wheeler
authors.forename: Elina
authors.initials: E
authors.lastname: Quiroga
authors.forename: Ted R
authors.initials: TR
authors.lastname: Kohler
authors.forename: Gale L
authors.initials: GL
authors.lastname: Tang
mesh_terms: D015746:Abdominal Pain / Q000382:microbiology; D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020878:Device Removal; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents