Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Apr 29:6:1-7.
doi: 10.4137/OJCS.S11446. eCollection 2013.

Ruptured thoracic aortic aneurysm infected with listeria monocytogenes: a case report and a review of literature

Shigeki Masuda  1 , Nobuhiro Takeuchi  1 , Masanori Takada  1 , Koichi Fujita  1 , Yoshiharu Nishibori  1 , Takao Maruyama  1
Affiliations
Case Reports

Ruptured thoracic aortic aneurysm infected with listeria monocytogenes: a case report and a review of literature

Shigeki Masuda et al. Open J Cardiovasc Surg. .

Abstract

A 75-year-old male with a history of alcoholic liver cirrhosis, sigmoid colon cancer, and metastatic liver cancer was admitted to our institution with a complaint of a prickly feeling in his chest. On admission, a chest radiograph revealed a normal cardio-thoracic ratio of 47%. Echocardiography revealed pericardial effusion and blood chemical analyses revealed elevated C-reactive protein levels (14.7 mg/dL). On day 3, chest radiography revealed cardiomegaly with a cardio-thoracic ratio of 58% and protrusion of the left first arch. Contrast-enhanced chest computed tomography revealed a saccular aneurysm in the aortic arch with surrounding hematoma; thus, a ruptured thoracic aortic aneurysm was suspected. Emergency surgery was performed, which revealed a ruptured aortic aneurysm with extensive local inflammation. The diagnosis of an infected aortic rupture was therefore confirmed. The aneurysm and abscess were resected, followed by prosthetic graft replacement and omental packing. Histopathology of the resected aneurysm revealed gram-positive bacilli; and Listeria monocytogenes was confirmed as the causative organism by culture. Postoperative course was uneventful; on postoperative day 60, the patient was ambulatory and was discharged. Here we report the case of a male with a ruptured thoracic aortic aneurysm infected with L. monocytogenes.

Keywords: Listeria monocytogenes; Thoracic aortic aneurysm.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Chest radiography on admission revealing a normal cardio-thoracic ratio of 47%. There is no evidence of cardiomegaly, pulmonary congestion, or the retention of pleural effusion (A). On admission, echocardiography revealed fluid retention in the pericardium of anterior and posterior walls of left ventricular. Ejection fraction was preserved with 55% (B).
Figure 2
Figure 2
On day 3, chest radiography revealed enlargement of the cardiac shadow (cardio-thoracic ratio of 58%) and the protrusion of the left first arch (A). On day 3, contrast-enhanced chest computed tomography revealed an ulcer-like projection along the lesser curvature of the aortic arch surrounded by a hematoma. At this point, a ruptured thoracic aortic aneurysm was suspected (B). Coronal view enhanced computed tomography revealed pericardial effusion (C).
Figure 3
Figure 3
Surgical findings. The thoracic aortic aneurysm with infection was exposed (A). The aneurysm was resected and the rifampicin-soaked prosthetic graft was placed (B). Surgical findings of the scheme revealed a saccular aortic aneurysm with calcification at the aortic arch (C). A rifampicin-soaked prosthetic graft was placed and the omentum was packed into the aortic aneurysm and around the circumference of the prosthetic graft (D).
See this image and copyright information in PMC

References

    1. Müller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg. 2001;33(1):106–3. - PubMed
    1. Hsu RB, Tsay YG, Wang SS, Chu SH. Surgical treatment for primary infected aneurysm of the descending thoracic aorta, abdominal aorta, and iliac arteries. J Vasc Surg. 2002;36(4):746–50. - PubMed
    1. Paulo N, Cascarejo J, Vouga L. Syphilitic aneurysm of the ascending aorta. Interact Cardiovasc Thorac Surg. 2012;14(2):223–5. - PMC - PubMed
    1. Blanchard JF, Armenian HK, Peeling R, Friesen PP, Shen C, Brunham RC. The relation between Chlamydia pneumoniae infection and abdominal aortic aneurysm: case-control study. Clin Infect Dis. 2000;30(6):946–7. - PubMed
    1. Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams TW., Jr Ann Thorac Surg; In situ prosthetic graft replacement for mycotic aneurysm of the aorta. ; 1989. pp. 193–203. - PubMed

Publication types

LinkOut - more resources