Listeria monocytogenes infectious periaortitis: a case report from the infectious disease standpoint.
Aged
Anti-Bacterial Agents
/ therapeutic use
Aortic Aneurysm, Abdominal
/ complications
Blood Culture
Ciprofloxacin
/ therapeutic use
Doxycycline
/ therapeutic use
Fluorodeoxyglucose F18
Humans
Listeria monocytogenes
/ pathogenicity
Listeriosis
/ diagnostic imaging
Male
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Reoperation
Retroperitoneal Fibrosis
/ diagnostic imaging
Stents
Tomography, X-Ray Computed
Anti-bacterial agents
Aortic repair
Culture-independent methods
Endograft infection
Etiologic bacterial diagnosis
Fastidious organisms
Listeria monocytogenes
Metagenomics
Microbiological techniques
Surgical sampling
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
16 Apr 2019
16 Apr 2019
Historique:
received:
22
04
2018
accepted:
04
04
2019
entrez:
18
4
2019
pubmed:
18
4
2019
medline:
6
7
2019
Statut:
epublish
Résumé
Endograft infection is a rare but extremely dangerous complication of aortic repair (25-100% of mortality). We describe here the first case of Listeria monocytogenes abdominal periaortitis associated with a vascular graft. We also discuss the differential diagnosis of periaortitis and provide a literature review of L. monocytogenes infectious aortitis. Nine months after endovascular treatment of an abdominal aortic aneurysm (abdominal stent graft), a 76-year-old man was admitted for severe abdominal pain radiating to the back. Laboratory tests were normal apart from elevated C-reactive protein (CRP). Injected abdominal computed tomography (CT) showed infiltration of the fat tissues around the aortic endoprosthesis and aneurysmal sac expansion; positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) showed a hypermetabolic mass in contact with the endoprosthesis. Blood cultures were negative. At surgical revision, an infra-renal peri-aortic abscess was evident; post-operative antibiotic therapy with ciprofloxacin and doxycycline was started. Cultures of intraoperative samples were positive for L. monocytogenes. Results were further confirmed by a broad-range polymerase chain reaction (PCR) and next-generation sequencing. Antibiotic treatment was switched to intravenous amoxicillin for 6 weeks. Evolution was uneventful with decrease of inflammatory parameters and regression of the abscess. An etiologic bacterial diagnosis before starting antibiotic therapy is paramount; nevertheless, culture-independent methods may provide a microbiological diagnosis in those cases where antimicrobials are empirically used and when cultures remain negative.
Sections du résumé
BACKGROUND
BACKGROUND
Endograft infection is a rare but extremely dangerous complication of aortic repair (25-100% of mortality). We describe here the first case of Listeria monocytogenes abdominal periaortitis associated with a vascular graft. We also discuss the differential diagnosis of periaortitis and provide a literature review of L. monocytogenes infectious aortitis.
CASE PRESENTATION
METHODS
Nine months after endovascular treatment of an abdominal aortic aneurysm (abdominal stent graft), a 76-year-old man was admitted for severe abdominal pain radiating to the back. Laboratory tests were normal apart from elevated C-reactive protein (CRP). Injected abdominal computed tomography (CT) showed infiltration of the fat tissues around the aortic endoprosthesis and aneurysmal sac expansion; positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) showed a hypermetabolic mass in contact with the endoprosthesis. Blood cultures were negative. At surgical revision, an infra-renal peri-aortic abscess was evident; post-operative antibiotic therapy with ciprofloxacin and doxycycline was started. Cultures of intraoperative samples were positive for L. monocytogenes. Results were further confirmed by a broad-range polymerase chain reaction (PCR) and next-generation sequencing. Antibiotic treatment was switched to intravenous amoxicillin for 6 weeks. Evolution was uneventful with decrease of inflammatory parameters and regression of the abscess.
CONCLUSION
CONCLUSIONS
An etiologic bacterial diagnosis before starting antibiotic therapy is paramount; nevertheless, culture-independent methods may provide a microbiological diagnosis in those cases where antimicrobials are empirically used and when cultures remain negative.
Identifiants
pubmed: 30991963
doi: 10.1186/s12879-019-3953-z
pii: 10.1186/s12879-019-3953-z
pmc: PMC6469050
doi:
Substances chimiques
Anti-Bacterial Agents
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Ciprofloxacin
5E8K9I0O4U
Doxycycline
N12000U13O
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
326Références
J Vasc Surg. 1999 Mar;29(3):554-6
pubmed: 10069921
Diagn Microbiol Infect Dis. 2004 Jan;48(1):63-7
pubmed: 14761724
Hum Pathol. 2004 Sep;35(9):1112-20
pubmed: 15343514
Ann Vasc Surg. 2004 Sep;18(5):521-6
pubmed: 15534730
Lancet. 2006 Jan 21;367(9506):241-51
pubmed: 16427494
Nucleic Acids Res. 2007 Jan;35(Database issue):D61-5
pubmed: 17130148
J Vasc Surg. 2008 Mar;47(3):635-7
pubmed: 18295117
Bioinformatics. 2010 Oct 1;26(19):2460-1
pubmed: 20709691
Br Med J. 1885 Mar 21;1(1264):577-9
pubmed: 20751204
Eur J Vasc Endovasc Surg. 2010 Nov;40(5):582-8
pubmed: 20843713
Bioinformatics. 2010 Dec 15;26(24):3125-6
pubmed: 20956244
J Vasc Surg. 2011 Aug;54(2):327-33
pubmed: 21397443
Case Rep Med. 2011;2011:482815
pubmed: 21765844
BMC Bioinformatics. 2011 Sep 30;12:385
pubmed: 21961884
Int J Surg Case Rep. 2013;4(7):626-8
pubmed: 23711639
Methods. 2013 Sep 1;63(1):41-9
pubmed: 23816787
Heart Lung Circ. 2014 Jan;23(1):24-31
pubmed: 24103706
Bioinformatics. 2014 Aug 1;30(15):2114-20
pubmed: 24695404
Front Cell Infect Microbiol. 2014 May 23;4:65
pubmed: 24904840
Rev Med Interne. 2015 Jan;36(1):15-21
pubmed: 25455951
Nat Methods. 2015 Oct;12(10):902-3
pubmed: 26418763
Aorta (Stamford). 2014 Jun 01;2(3):93-9
pubmed: 26798723
Open Forum Infect Dis. 2015 Dec 17;3(1):ofv203
pubmed: 26835477
Cardiovasc Pathol. 2016 Sep-Oct;25(5):432-41
pubmed: 27526100
Gefasschirurgie. 2016;21(Suppl 2):80-86
pubmed: 27546992
Circulation. 2016 Nov 15;134(20):e412-e460
pubmed: 27737955
Ann Vasc Surg. 2017 Jul;42:307.e1-307.e6
pubmed: 28323232
Int J Mol Sci. 2017 Sep 20;18(9):null
pubmed: 28930150
Front Microbiol. 2018 Jul 17;9:1566
pubmed: 30065706
Am J Clin Pathol. 1966 Apr;45(4):493-6
pubmed: 5325707
Histopathology. 1994 Jan;24(1):23-32
pubmed: 7511559