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• W1520222079 abstract "Since the advent of antibiotics, there has been a striking decrease in the incidence of mycotic aneurysms and an accompanying increase of secondary infection in aortic aneurysms. The predominant organism in these cases is salmonella which has an unexplained predilection for damaged vessel wall. Staphylococci are second in incidence. Thirty-four cases of secondarily infected aortic aneurysms have been reported in the literature, but there is presumptive evidence that the incidence is much higher. Failure of the pathologist to take multiple sections and cultures of ruptured aneurysms may result in the misdiagnosis of these lesions, and their histologic differentiation from myocotic aneurysm is not always easy. Although the normal aortic wall is highly resistant to infection, the damaged intima and thrombus in the aneurysm provide a good portal of entry and culture medium for bacterial infection. The majority of infected aneurysms are of arteriosclerotic origin, which largely explains the predominance of infected aneurysms in the abdominal aorta of elderly male patients. The clinical diagnosis of infected aortic aneurysm is difficult to make since symptoms are usually related to primary infection elsewhere in the body, to chronic sepsis, or to leakage or rupture of the aneurysm. The one common sign is fever, which was present in all but one patient, was often prolonged, and usually over 102 °F. Fever is not a sign of the ordinary leaking aneurysm and should alert the clinician to the possibility of infection of the aneurysm as should the isolation of salmonellae in blood culture. The eventual outcome of an infected aneurysm is fatal rupture. Only surgical resection can effect a cure because antibiotics cannot sterilize these lesions. Six patients have undergone resection and grafting, all with fatal results, illustrating the hazards of recurrent infection and vascular disruption after graft procedures in an infected field. Earlier diagnosis will hopefully permit successful resection and graft replacement of the infected aortic aneurysm prior to rupture and change what to date has been a uniformly fatal prognosis." @default.
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• W1520222079 date "1967-03-01" @default.
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• W1520222079 title "Bacterial infection of aortic aneurysms" @default.
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• W1520222079 doi "https://doi.org/10.1016/0002-9610(67)90273-5" @default.
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