title: Thoracic Aortic Graft Infections Secondary to Propionibacterium Species: Two Cases and Review of the Literature.
abstract: Aortic graft infections are a rare occurrence, most commonly secondary to gram-positive organisms (Staphylococcus and Streptococcus species). We present 2 cases of thoracic aortic graft infections secondary to anaerobic bacteria, Propionibacterium species. The first case, a 40-year-old male, was found to have an anastomotic aneurysm at the distal anastomosis of a previous thoracoabdominal aneurysm repair. During the open repair of his anastomotic aneurysm, the original graft was not incorporated and cultures later speciated Propionibacterium acnes The second case is a 44-year-old male with a history of abdominal aortic coarctation that was repaired with a thoracic aorta to aortic bifurcation graft as a child who presented with flank pain and was found on imaging to have fluid around his bypass graft. His operating room (OR) cultures also grew out Propionibacterium species. Both patients were treated with graft excision, revascularization, and long-term antibiotics. Anaerobic bacteria are a rare cause of aortic graft infections. Upon review of the literature, these are the first 2 cases of thoracic aortic graft infections secondary to Propionibacterium species. The cultures for both patients took almost a week to speciate, highlighting the importance of following cultures long term. Anaerobic bacteria should be recognized as a cause of latent graft infections.
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA danielle.pineda@gmail.com.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Pineda
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Tyagi
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Dougherty
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Troutman
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Calligaro
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / 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*; D000072226:Computed Tomography Angiography; D020878:Device Removal; D016908:Gram-Positive Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Propionibacterium species; anaerobic bacteria; aortic graft infections