Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report
The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During h...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/6/620 |
| _version_ | 1797530220357484544 |
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| author | Muzammil H. Syed Mark Wheatcroft Danny Marcuzzi Hooman Hennessey Mohammad Qadura |
| author_facet | Muzammil H. Syed Mark Wheatcroft Danny Marcuzzi Hooman Hennessey Mohammad Qadura |
| author_sort | Muzammil H. Syed |
| collection | DOAJ |
| description | The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management. |
| first_indexed | 2024-03-10T10:25:54Z |
| format | Article |
| id | doaj.art-f23c1b450a9a4ce4855d6b0e36c8edf9 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T10:25:54Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-f23c1b450a9a4ce4855d6b0e36c8edf92023-11-22T00:01:41ZengMDPI AGMedicina1010-660X1648-91442021-06-0157662010.3390/medicina57060620Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case ReportMuzammil H. Syed0Mark Wheatcroft1Danny Marcuzzi2Hooman Hennessey3Mohammad Qadura4Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, CanadaDivision of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, CanadaDepartment of Diagnostic Imaging, St. Michael’s Hospital, Toronto, ON M5B 1W8, CanadaDivision of Vascular and Interventional Radiology, Health Sciences North, Northern Ontario School of Medicine, Sudbury, ON M5B 1W8, CanadaDivision of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, CanadaThe aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management.https://www.mdpi.com/1648-9144/57/6/620mycotic aneurysmCOVID-19endovascular stentsrifampinKlebsiella pneumoniaeendoleak |
| spellingShingle | Muzammil H. Syed Mark Wheatcroft Danny Marcuzzi Hooman Hennessey Mohammad Qadura Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report Medicina mycotic aneurysm COVID-19 endovascular stents rifampin Klebsiella pneumoniae endoleak |
| title | Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report |
| title_full | Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report |
| title_fullStr | Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report |
| title_full_unstemmed | Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report |
| title_short | Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report |
| title_sort | management of a mycotic aneurysm in a patient with covid 19 a case report |
| topic | mycotic aneurysm COVID-19 endovascular stents rifampin Klebsiella pneumoniae endoleak |
| url | https://www.mdpi.com/1648-9144/57/6/620 |
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