Table 1.
Reported cases of Streptococcus pyogenes aortic aneurysm infection.
| Case (ref) | Age /Sex | Site | Surgical treatment | Medical treatment (empiric; directed) | Outcome |
|---|---|---|---|---|---|
| 1(5) | 65/M | Infrarenal abdominal aorta | Resection with right axillary femoro-femoral bypass graft (day 1) | Ampicillin-sulbactam & aztreonam: nafcillin & penicillin G | Died 40 hours after admission |
| 2(6) | 58/F | Infrarenal abdominal aorta | Aorto-bifemoral graft | Not discussed “antibiotics” | Lumbar plexopathy and flaccid paralysis; walking with sticks at 18 months |
| 3(7) | 36/M | Aberrant origin right subclavian artery | Ligation of aberrant artery; aortic arch repair with Hemashield graft (day2) | Not discussed “parenteral antibiotics” | Death day 8 – brain death due to diffuse brain ischemia, obstructive hydrocephalus due to cerebellar infarct, & transverse sinus thrombosis |
| 4(8) | 1.5/F | Ascending aorta | Aneurysmectomy + valveless aortic homograft on day 8 | Cefuroxime & gentamicin; high dose penicillin G (6 weeks), oral penicillin (3 months) | Well and active at 12 months |
| 5(9) | 81/M | Abdominal aorta, vertebral osteomyelitis, bilateral psoas abscess | None | Not discussed | Died (aneurysm rupture) |
| 6(10) | 72/M | Thoraco-abdominal aorta | Open resection & prosthetic graft implanatation (rifampicin-impregnated) | Vancomycin & imipenem; penicillin G (4 million units q4h 12 days), benzathine penicillin 1yr | Well at 6 months on penicillin |
| 7(11) | 63/F | Thoraco-abdominal aorta | Open Type IV repair (3 weeks after diagnosis) | Not discussed | Alive at 87 months |
| 8(12) | 2/M | Descending thoracic aorta | Open Dacron repair (day 3) and re-operation due to recurrence proximal to original graft | Ceftriaxone, ampicillin-sulbactam; clindamycin & ampicillin (6 weeks) | Well at 6 weeks |
| 9 (current report) | 60/M | Infrarenal abdominal aorta | Initial endoluminal repair, complicated by secondary graft infection requiring graft excision & axillary-bifemoral bypass | Vancomycin, ceftriaxone & metronidazole; benzylpenicillin (5 weeks) piperacillin-tazobactam (6 weeks), amoxicillin-clavulanate (lifelong) | Well at 4 months, on amoxicillin-clavulanate |