Management of ruptured abdominal aortic aneurysm infected with Listeria monocytogenes in a patient with poor dentition

Abstract

Purpose: Despite initial description of mycotic aneurysms dating back to late 19th century, there are relatively few reported cases of listeriosis in an abdominal aortic aneurysm and a lack of optimal treatment consensus. In this case study, we report a rare case of a ruptured mycotic abdominal aortic aneurysm (AAA) caused by Listeria monocytogenes followed by a brief review of the relevant literature. Our case presents a novel infection source, thought to be from the patient's extensive dental caries. Case presentation: The patient was a 68-year-old male who presented with severe back pain and syncope with Computed Tomography (CT) findings of a ruptured paravisceral aorta with an 8.3 cm retroperitoneal pseudoaneurysm. He underwent an emergent open thoracoabdominal aortic repair with a rifampin soaked Coselli graft with bilateral renal artery bypasses with extensive debridement of the infected aortic tissue. Post-operatively, his cultures were positive for Listeria monocytogenes, and he was treated with long term antibiotics. Despite being discharged after an uneventful post-operative course, he presented to the hospital three weeks later with a ruptured proximal anastomosis and passed away.

Keywords

• Mycotic abdominal aortic aneurysm
• Listeria monocytogenes
• Bacteremia of dental origin