Management of infected abdominal aortic aneurysm associated with vertebral destruction due to chronic leak

Abstract

We report a case of a patient with an infected abdominal aortic aneurysm due to Staphylococcus versus Brucellar spine infection complicated by aortic aneurysm with chronic contained leak. A 75-year-old patient who had a history of Brucellosis 4 years ago presented one year later with 4.5 cm infra renal abdominal aortic aneurysm (AAA). He presented with aggravated acute abdominal pain radiating to the back and right hip, loss of weight, anorexia, and malaise. The CT-scan showed an AAA of size 6.5 cm involving infra-renal abdominal aorta with erosion of the body of lumbar vertebrae L3 and L4, and stretching of psoas muscle by a chronic contained posterior leak. Investigations showed erythrocyte sedimentation rate of 30, C-reactive proteins of 89, and the Brucella titer was negative. The diagnosis was infected aneurysm and the patient underwent axillo bifemoral bypass and ligation of aorta below the renal arteries. Tissue culture postoperatively showed coagulase negative Staphylococcus.