In Situ Replacement with Rifampicin-Soaked Vascular Prosthesis in a Patient with Abdominal Aortic Aneurysm Infected by Listeria monocytogenes and Presenting with Symptoms of Leriche Syndrome

iDepartment of Cardiovascular Surgery, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japanj

Tsuyoshi Hachimaru Masazumi Watanabe Satoru Kawaguchi
Hideki Nakahara
A 72-year-old man presented with low back pain, intermittent claudication, atrophy of the muscle of the lower extremities, and impotence. Laboratory tests revealed inflammation, and computed tomography showed an abdominal aortic aneurysm with severe stenosis of the terminal aorta. Consequently, we diagnosed an infected aortic aneurysm and antibiotics were administered intravenously. Bacterial culture of the blood on admission demonstrated Listeria monocytogenes. On day 27 after admission, in situ replacement with a rifampicin-soaked vascular prosthesis and omentopexy were performed. After the surgery, intermittent claudication, atrophy of the muscles of the lower extremities, and impotence improved dramatically. The postoperative course was uneventful. Antibiotics were administered for a long period, and the C-reactive protein levels decreased to a normal range. For 18 months thereafter, the patient has been doing well without any sign of infection.
  Jpn. J. Cardiovasc. Surg. 38:344-348i2009j