TY - JOUR
T1 - A rare case of infectious aortitis caused by Burkholderia pseudomallei
AU - Dodd, James
AU - Mwipatayi, Bibombe
AU - Louw, Amber
AU - Joseph, Simon
AU - Picazo-Pineda, Fernando
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/12
Y1 - 2024/12
N2 - Introduction: Melioidosis is caused by Burkholderia pseudomallei and primarily affects non-vascular organ systems. We present a case of a melioidotic penetrating aortic ulcer (PAU) with unusual clinical features of vascular infection. The patient was successfully treated with a single-stage neoaortoiliac system procedure, highlighting the challenges in managing melioidotic aortic infections. Presentation of case: We present a case of melioidotic PAU that was successfully treated using a single-stage neoaortoiliac system procedure. A 70-year-old male with type 2 diabetes and ischemic heart disease presented with acute abdominal and back pain, later found to have an infrarenal PAU without aneurysmal changes. Following an emergency endovascular aortic repair (EVAR), blood cultures revealed Burkholderia pseudomallei bacteraemia, leading to the diagnosis of melioidosis-associated aortitis. The patient underwent a complex surgical procedure to remove the infected aorta and reconstruct it using a neoaortoiliac system, followed by a challenging recovery that included wound infection, prolonged antibiotic therapy, and subsequent hospitalization for sepsis. Despite complications, the patient remains alive and functionally independent 15 months post-surgery. Discussion: Burkholderia pseudomallei, found in contaminated soil and water, can lead to severe infections, including mycotic aneurysms, with a high mortality rate despite treatment. Management of vascular involvement is complex, often requiring emergency interventions like EVAR to enable survival for definitive treatment. Conclusion: This case emphasizes the importance of recognizing melioidosis as a potential cause of infectious aortitis, particularly in patients with a travel history to endemic regions.
AB - Introduction: Melioidosis is caused by Burkholderia pseudomallei and primarily affects non-vascular organ systems. We present a case of a melioidotic penetrating aortic ulcer (PAU) with unusual clinical features of vascular infection. The patient was successfully treated with a single-stage neoaortoiliac system procedure, highlighting the challenges in managing melioidotic aortic infections. Presentation of case: We present a case of melioidotic PAU that was successfully treated using a single-stage neoaortoiliac system procedure. A 70-year-old male with type 2 diabetes and ischemic heart disease presented with acute abdominal and back pain, later found to have an infrarenal PAU without aneurysmal changes. Following an emergency endovascular aortic repair (EVAR), blood cultures revealed Burkholderia pseudomallei bacteraemia, leading to the diagnosis of melioidosis-associated aortitis. The patient underwent a complex surgical procedure to remove the infected aorta and reconstruct it using a neoaortoiliac system, followed by a challenging recovery that included wound infection, prolonged antibiotic therapy, and subsequent hospitalization for sepsis. Despite complications, the patient remains alive and functionally independent 15 months post-surgery. Discussion: Burkholderia pseudomallei, found in contaminated soil and water, can lead to severe infections, including mycotic aneurysms, with a high mortality rate despite treatment. Management of vascular involvement is complex, often requiring emergency interventions like EVAR to enable survival for definitive treatment. Conclusion: This case emphasizes the importance of recognizing melioidosis as a potential cause of infectious aortitis, particularly in patients with a travel history to endemic regions.
KW - Burkholderia pseudomallei
KW - Case report
KW - Infective aortitis
KW - Melioidosis
KW - Penetrating aortic ulcer
UR - http://www.scopus.com/inward/record.url?scp=85207782962&partnerID=8YFLogxK
U2 - 10.1016/j.ijscr.2024.110424
DO - 10.1016/j.ijscr.2024.110424
M3 - Article
C2 - 39476718
AN - SCOPUS:85207782962
SN - 2210-2612
VL - 125
JO - International Journal of Surgery Case Reports
JF - International Journal of Surgery Case Reports
M1 - 110424
ER -