A case of Infective Native (Abdominal) Aortic Aneurysm Caused by Streptococcus Agalactiae: An Updated Literature Review Based on New Nomenclature

Ann Vasc Surg. 2021 Aug:75:531.e7-531.e13. doi: 10.1016/j.avsg.2021.01.105. Epub 2021 Apr 6.

Abstract

The management of abdominal aortic aneurysms (AAA) has evolved significantly with the advent of endovascular strategies. Thus, there has been a decline in the number of open AAA repairs once an endovascular option is available. There have also been reports of successful endovascular management of infective native aortic aneurysms (INAA)1, previously called mycotic aneurysms2. The rarity of this condition makes its management a challenging one as there are no standard guidelines. The European Society of Vascular Surgery has suggested that the nomenclature be changed from mycotic aneurysms as this can be misleading to standardise reporting1. The authors' present a case of a 67-year old male who presented during the peak of the Corona Virus pandemic with constitutional gastrointestinal symptoms. He was subsequently diagnosed with an INAA and successfully managed with open Neo-Aorto Iliac System reconstruction with a homograft3. The report highlights various strategies used in the surgical approach and their benefits in the management of INAA. Furthermore, a literature review of Streptococcus (Streptococcus agalactiae) species as a rare cause of INAA and how these cases were managed are also highlighted.

Keywords: Group B Streptococcus; Infective native aortic aneurysm; Inflammatory aneurysm; Mycotic aortic aneurysm; Neo-Aorto Iliac System Reconstruction; Streptococcus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Allografts
  • Aneurysm, Infected / diagnosis
  • Aneurysm, Infected / microbiology
  • Aneurysm, Infected / surgery*
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / microbiology
  • Aortic Aneurysm, Abdominal / surgery*
  • Humans
  • Iliac Artery / transplantation*
  • Male
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / surgery*
  • Streptococcus agalactiae / isolation & purification*
  • Treatment Outcome
  • Vascular Grafting*

Substances

  • Anti-Bacterial Agents