2012 Volume 21 Issue 4 Pages 619-622
We report the case of a 63-year-old man with severe lumbago and an exercise disorder of the right lower extremity of unknown etiology. He had been previously been seen by an orthopedic surgeon and a urological surgeon for several months. Computed tomography (CT) revealed a huge infrarenal abdominal aortic aneurysm (AAA) with a diameter of 120 mm that had spread into the retroperitoneal space and caused lumbar vertebral erosion. A hematological examination revealed mild anemia and an elevated C-reactive protein (CRP) level. However, his hemodynamics were stable. Chronic rupture of an AAA was diagnosed, and emergency surgery was performed. The intraoperative findings included a broad punched-out defect on the posterior wall of the AAA. There was no evidence of any infectious abscess. He became febrile on the 7th postoperative day, but otherwise his general condition was good. However, a CT scan obtained 10 days later revealed massive fluid collection with air surrounding the prosthetic graft body and limbs. The CT and physical findings indicated graft infection and infective spondylitis. A culture of fluid aspirated under CT guidance revealed the presence of Campylobacter species. His neuropathy of the right lower limb gradually improved with corset treatment and physical rehabilitation. The patient was discharged 47 days postoperatively under an oral antibiotic that was effective against the cultured organism. The patient’s condition has been maintained on long-term systemic antibiotic therapy, and he has been doing well with no recurrence of infection 21 months after the operation.
