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Mycotic Aneurysm Caused by Streptococcus constellatus subsp. constellatus.

ABSTRACT: An infected mycotic aneurysm due to Streptococcus constellatus subsp. constellatus has not previously been reported. We report on this condition in an 87-year-old woman who had aggravating abdominal pain and a large fusiform aneurysm over the thoracic-abdominal aorta with mural thrombus. Isolates from two sets of blood cultures and the debrided tissue were identified as S. constellatus subsp. constellatus by their biochemical reaction profiles, compatible 16S rRNA gene sequencing results, and sequencing results for the partial groESL gene and the 16S-23S intergenic spacer region.

SUBMITTER: Chiang WC

PROVIDER: S-EPMC387616 | biostudies-literature | 2004 Apr

REPOSITORIES: biostudies-literature

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Mycotic Aneurysm Caused by Streptococcus constellatus subsp. constellatus.

Chiang Wen-Chu WC Tsai Jui-Chang JC Chen Shey-Ying SY Hsu Chiung-Yuan CY Wu Chen-Tu CT Teng Lee-Jene LJ Hsueh Po-Ren PR

Journal of clinical microbiology 20040401 4

An infected mycotic aneurysm due to Streptococcus constellatus subsp. constellatus has not previously been reported. We report on this condition in an 87-year-old woman who had aggravating abdominal pain and a large fusiform aneurysm over the thoracic-abdominal aorta with mural thrombus. Isolates from two sets of blood cultures and the debrided tissue were identified as S. constellatus subsp. constellatus by their biochemical reaction profiles, compatible 16S rRNA gene sequencing results, and se ...[more]

PMID: 15071061

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Project description:IntroductionInfective endocarditis and mycotic tibioperoneal aneurysms are rare complications of COVID-19 infection. Medical therapy may not always be sufficient to reduce the high morbidity and mortality associated with these cardiovascular complications. Surgical treatment may need to be considered in such patients.ReportA 56 year old male patient with diabetes, hypertension, and hyperlipidaemia developed severe pneumonia from COVID-19 infection. He was admitted to the intensive care unit (ICU) at another facility where he was ventilated for a period of six weeks. Blood culture isolated coagulase-negative Staphylococcus and an echocardiogram showed a 1.4 × 1.5 cm mitral valve vegetation. He was treated for a period of 12 weeks with various antibiotic combinations including meropenem, levofloxacin, and teicoplanin with no improvement. On presentation at the current centre, he complained of painful right calf swelling. Computed tomography angiography showed a 7 cm right tibioperoneal trunk aneurysm. He underwent lung and cardiac assessment, following which it was decided to proceed with one stage synchronous surgery. Cardiac surgery was started through a median sternotomy and Guiraudon transeptal approach, with mitral valve replacement using a bioprosthesis (Edwards Magna, size 29). This was immediately followed by a medial lower limb approach with ligation of the aneurysm, followed by arterial reconstruction using a reversed saphenous vein graft from the superficial femoral artery to the posterior tibial artery. He was placed on intravenous vancomycin and ceftriaxone for a period of six weeks. He was discharged home after day 31 on 75 mg aspirin daily. At six month follow up, he was symptom free with a palpable posterior tibial pulse.DiscussionIncreased awareness and close surveillance are necessary for patients with severe COVID-19 infection. In those who develop unusual cardiovascular complications, one stage cardiac and vascular surgery may be feasible, as described in this case.

Dataset Information

Mycotic Aneurysm Caused by Streptococcus constellatus subsp. constellatus.

Publications

Mycotic Aneurysm Caused by Streptococcus constellatus subsp. constellatus.

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