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两例因主动脉移植材料感染导致的真菌性动脉瘤

Two Cases of Mycotic Aneurysms Caused by Infection of Aortic Graft Material.

作者信息

Mize Brandi M, Laskey Emily, Damhorst Gregory L, Kraft Colleen S, Escobar Guillermo A

机构信息

Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia, USA.

School of Medicine, Emory University, Atlanta, Georgia, USA.

出版信息

Open Forum Infect Dis. 2025 Jul 9;12(7):ofaf404. doi: 10.1093/ofid/ofaf404. eCollection 2025 Jul.

Abstract

, a zoonotic pathogen, can affect multiple human organ systems causing various clinical manifestations. While aortoiliac involvement is rare worldwide, we report 2 cases of aortic brucellosis following abdominal aortic aneurysm repairs within a 9-year period at a single US institution in Georgia. One case was an infected aortic endograft, which may be the first reported. aortoiliac infections are rare even in endemic areas, thus highlighting how uncommon these cases are in Georgia. Acknowledging the dismal prognosis with symptomatic aortic graft infections, we wish to share our experience in successfully treating them, including an infected aortic endograft. We recommend obtaining a robust history when evaluating individuals with suspected mycotic aneurysms who frequently handle animals. Education on protective equipment and proper handling of animals is imperative to reduce the risk of aortic graft brucellosis infections. Our institutional experience suggests that graft explantation and doxycycline-rifampin are acceptable treatment options.

摘要

布鲁氏菌作为一种人畜共患病原体,可影响人体多个器官系统,引发各种临床表现。虽然在全球范围内,主动脉髂动脉受累情况较为罕见,但我们报告了在美国佐治亚州一家机构9年内发生的2例腹主动脉瘤修复术后主动脉布鲁氏菌病病例。其中1例为感染性主动脉内移植物,这可能是首次报道。即使在布鲁氏菌病流行地区,主动脉髂动脉感染也很罕见,这凸显了这些病例在佐治亚州的罕见程度。鉴于有症状的主动脉移植物感染预后不佳,我们希望分享成功治疗这些病例的经验,包括感染性主动脉内移植物的治疗经验。我们建议在评估经常接触动物且疑似患有霉菌性动脉瘤的个体时,详细了解病史。必须开展关于防护设备和动物正确处理方法的教育,以降低主动脉移植物布鲁氏菌病感染的风险。我们机构的经验表明,移植物切除和强力霉素 - 利福平是可接受的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf1/12281501/c0d090861e17/ofaf404f1.jpg

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