2024 Volume 33 Issue 5 Pages 293-297
Although infected abdominal aortic aneurysms is known to be associated with pyogenic spondylitis, reports of stent graft infection complicated by pyogenic spondylitis are rare and the primary cause is often unclear. We report a successfully treated case of abdominal stent graft infection attributed to pyogenic spondylitis. The patient was a 75-year-old man who underwent stent graft insertion for abdominal aortic aneurysm 10 years earlier and the aneurysm remained reduced in size. At this presentation, he complained of fever and lower back pain and was admitted with diagnoses of pyogenic spondylitis, iliopsoas abscess, and subcutaneous abscess of the right lower leg. Treatment with antibiotics led to improvement and he was discharged, but back pain recurred a month later. Because some images revealed signs of abdominal stent graft infection, we performed stent graft removal and in situ replacement using rifampicin-bonded grafting and omental pedicle grafting. He was discharged home on post-operative day 22, and the infection has not recurred since completing the course of antibiotics. Development of pyogenic spondylitis in the presence of a stent graft poses a risk of infection spreading to the stent graft, so prompt intervention is imperative. If infection spreads to the stent graft, early radical surgery is desirable if feasible.
