A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks. Symptomatic recovery occurred after 21 days. On the 30th day, we deployed a stent to treat a new pseudoaneurysm. Three years later, the patient had no signs of persistent or recurrent infection. We think that this is the first report of aortic endograft infection caused by colistin-resistant, carbapenemase-producing K. pneumoniae.

A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks. Symptomatic recovery occurred after 21 days. On the 30th day, we deployed a stent to treat a new pseudoaneurysm. Three years later, the patient had no signs of persistent or recurrent infection. We think that this is the first report of aortic endograft infection caused by colistin-resistant, carbapenemase-producing K. pneumoniae.

Open conversion after aortic endograft infection. Caused by colistin-resistant, carbapenemase-producing Klebsiella pneumoniae / Montelione, Nunzio; Menna, Danilo; Sirignano, Pasqualino; Capoccia, Laura; Mansour, WASSIM AHMAD; Speziale, Francesco. - In: TEXAS HEART INSTITUTE JOURNAL. - ISSN 0730-2347. - STAMPA. - 43:5(2016), pp. 453-457. [10.14503/THIJ-15-5265]

Open conversion after aortic endograft infection. Caused by colistin-resistant, carbapenemase-producing Klebsiella pneumoniae

MONTELIONE, NUNZIO
;
MENNA, DANILO;SIRIGNANO, PASQUALINO;CAPOCCIA, LAURA;MANSOUR, WASSIM AHMAD;SPEZIALE, Francesco
2016

Abstract

A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks. Symptomatic recovery occurred after 21 days. On the 30th day, we deployed a stent to treat a new pseudoaneurysm. Three years later, the patient had no signs of persistent or recurrent infection. We think that this is the first report of aortic endograft infection caused by colistin-resistant, carbapenemase-producing K. pneumoniae.
2016
A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks. Symptomatic recovery occurred after 21 days. On the 30th day, we deployed a stent to treat a new pseudoaneurysm. Three years later, the patient had no signs of persistent or recurrent infection. We think that this is the first report of aortic endograft infection caused by colistin-resistant, carbapenemase-producing K. pneumoniae.
Abdominal/ surgery; Anti-bacterial agents/therapeutic use; Aortic aneurysm; Bacterial infections/ drug therapy/etiology/microbiology; Blood vessel prosthesis implantation/adverse effects; Combination; Drug therapy; Endovascular procedures/adverse effects; Klebsiella pneumoniae/drug effects/growth & development; Postoperative complications; Prosthesis-related infections/diagnosis/drug therapy/microbiology/surgery; Treatment outcome; Cardiology and Cardiovascular Medicine
01 Pubblicazione su rivista::01i Case report
Open conversion after aortic endograft infection. Caused by colistin-resistant, carbapenemase-producing Klebsiella pneumoniae / Montelione, Nunzio; Menna, Danilo; Sirignano, Pasqualino; Capoccia, Laura; Mansour, WASSIM AHMAD; Speziale, Francesco. - In: TEXAS HEART INSTITUTE JOURNAL. - ISSN 0730-2347. - STAMPA. - 43:5(2016), pp. 453-457. [10.14503/THIJ-15-5265]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/912203
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