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Pasteurella Multiocida infection resulting in a descending thoracic aorta mycotic pseudoaneurysm
Author(s) -
Jeng Eric I.,
Acosta Gianna,
Martin Tomas D.,
Upchurch Gilbert R.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14776
Subject(s) - medicine , pseudoaneurysm , thoracic aorta , descending aorta , mycotic aneurysm , aorta , radiology , surgery , aneurysm
Objective Highlight our management of a Pasteurella Multiocida ‐infected descending thoracic aorta mycotic pseudoaneurysm. Methods Report a case of a canine bite resulting in a P. Multiocida descending thoracic aorta mycotic pseudoaneurysm. Results We present a 61‐year‐old gentleman who was initially seen in an emergency department after a canine bite. He was admitted and treated with a course of IV antibiotics for P. Multiocida bacteremia and discharged. Three weeks after discharge, he continued to feel generalized malaise and work‐up was significant for a descending thoracic aorta mycotic pseudoaneurysm. The patient underwent a low left posterior lateral thoracotomy and femoral–femoral cardiopulmonary bypass for complete pseudoaneurysm resection and aortic replacement with a 24‐mm Gelweave graft. Given purulence and gross infection, we planned for a staged approach, with a secondary washout and omental flap for biologic coverage of the graft. The patient did well clinically and was discharged at 14 days to rehabilitation with 6‐week intravenous course of antibiotics. Conclusions The patient's clinical course with subsequent follow‐up suggest that complete resection of the mycotic pseudoaneurysm, followed by omental flap coverage is a viable strategy to manage mycotic aortic infections with virulent organisms.