Mycotic Aortic Aneurysm Caused by Multidrug-Resistant Enterobacteriaceae in an Elderly Patient: A Diagnostic Challenge

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DOI:

https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v46i3.1325

Keywords:

aortic aneurysm, aneurysm infected, Enterobacteriaceae, bacteremia, frailty

Abstract

We report the case of an 86-year-old patient with a complex urological history who presented with fever and generalized weakness. Bloodstream infection was documented and initially attributed to a urinary source, based on the presence of urolithiasis and a positive urine culture for multidrug-resistant Enterobacteriaceae. Targeted antibiotic therapy was therefore initiated.

However, the patient showed persistent fever and sustained elevation of inflammatory markers despite appropriate antimicrobial treatment. Computed tomography subsequently revealed a saccular aneurysm of the abdominal aorta, which was further confirmed as a mycotic aneurysm by positron emission tomography. Given the patient’s advanced age and frailty, a conservative management strategy with prolonged antibiotic therapy was selected. The patient showed a favorable clinical outcome.

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References

Oderich GS, Panneton JM, Bower TC, et al. Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg. 2001;34(5):900-908.

Sörelius K, Budtz-Lilly J, Mani K, Wanhainen A. Systematic review of the management of mycotic aortic aneurysms. Eur J Vasc Endovasc Surg. 2019;58(3):426-435.

Wilson WR, Bower TC, Creager MA, et al. Vascular graft infections, mycotic aneurysms, and endovascular infections: a scientific statement from the American Heart Association. Circulation. 2016;134(20):e412-e460.

Zhang N, Xiong W, Li Y, et al. Imaging features of mycotic aortic aneurysms. Quant Imaging Med Surg. 2021;11(6):2861-2878.

Goldstein SA, Evangelista A, Abbara S, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the American Society of Echocardiography and the European Association of Cardiovascular Imaging: endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2015;28(2):119-182.

Husmann L, Huellner MW, Ledergerber B, et al. Diagnostic accuracy of PET/CT and contrast enhanced CT in patients with suspected infected aortic aneurysms. Eur J Vasc Endovasc Surg. 2020;59(6):972-981.

Lin CH, Hsu RB. Primary infected aortic aneurysm: clinical presentation, pathogen, and outcome. Acta Cardiol Sin. 2014;30(6):514-521.

Kim YW. Infected aneurysm: current management. Ann Vasc Dis. 2010;3(1):7-15. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489-95.

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Published

2026-09-28

How to Cite

1.
Games AM, Rossetti S, Braslavsky A, Martingano I, Barrera T. Mycotic Aortic Aneurysm Caused by Multidrug-Resistant Enterobacteriaceae in an Elderly Patient: A Diagnostic Challenge. Rev Hosp Ital B.Aires [Internet]. 2026 Sep. 28 [cited 2026 Sep. 28];46(3):e0001325. Available from: https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/1325

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