Aortoiliac aneurysms infected by Campylobacter fetus
Received 12 March 2008; accepted 28 May 2008. published online 11 August 2008.
Purpose
Few reports of aortoiliac aneurysms infected by Campylobacter fetus are available. We report five cases and review previous reports, with a view to describing the clinical pattern, treatment options, and outcome of this infection.
Methods
During a 10-year period, 21 patients were diagnosed with C fetus infection in the Department of Clinical Microbiology, five of whom had an infected arterial aneurysm. We retrospectively reviewed their medical charts. Diagnosis was made on the basis of clinical presentation, computed tomography scan, perioperative findings, and identification of C fetus in at least one blood culture or culture from an aneurysm specimen. Late outcome of surviving patients was assessed by telephone interview.
Results
We identified four aortic aneurysms and one hypogastric aneurysm. All patients were seen in an emergency setting. Five had fever and abdominal pain, and three had contained rupture. Campylobacter fetus was found in blood cultures of four patients and in the aneurysm specimen of one patient. Three patients were treated by open repair and two by endovascular repair. One patient treated endovascularly died from septic shock due to C fetus at 2 weeks. One patient treated by open surgery underwent reoperation for persistent infection. The remaining patients were cured, but one died at 5 months of an unrelated cause. All surviving patients received long-term antibiotic therapy.
Conclusion
Campylobacter fetus infection of aortoiliac aneurysms is a serious condition with a high rate of rupture. However, long-term success can be obtained with prompt surgical treatment and an appropriate antibiotic regimen. The benefits of stent grafts remain debatable.
aDepartment of Vascular Surgery, Henri Mondor Hospital, Créteil, France
bDepartment of Medical Microbiology and Infectious Diseases, Henri Mondor Hospital, Créteil, France
Reprint requests: Frédéric Cochennec, Henri Mondor Hospital, 51 av du Maréchal de Lattre de Tassigny, 94000 Créteil, France
ABSTRACT