Pasteurella Multiocida Infection Resulting in a Descending Thoracic
Aorta Mycotic Pseudoaneurysm
Title: Pasteurella Multiocida Infection Resulting in a Descending
Thoracic Aorta Mycotic Pseudoaneurysm Objective: Highlight our
management of a P. Multiocida infected descending thoracic aorta mycotic
pseudoaneurysm Methods: Report a case of canine bite resulting in a P.
Multiocida descending thoracic aorta mycotic pseudoaneurysm Results: We
present a 61-year-old gentleman who was initially seen in an Emergency
Department after a canine bite. He was admitted and treated with a
course of IV antibiotics for P. Multiocida bacteremia and discharged.
Three weeks post discharge, he continued to feel generalized malaise and
work-up was significant for a descending thoracic aorta mycotic
pseudoaneurysm. The patient underwent a low left posterior lateral
thoracotomy and femoral-femoral cardiopulmonary bypass for complete
resection and replacement with a 24 mm GelweaveTM graft (Terumo
Cardiovascular Group, Ann Arbor, Michigan). Given purulence and gross
infection we planned for a staged approach, with a secondary washout and
omental flap for biologic coverage of the graft. The patient did well
clinically and was discharged at 14 days to rehabilitation with six-week
intravenous course of antibiotics. Conclusions: The patient’s clinical
course with subsequent follow-up suggest that complete resection of the
mycotic pseudoaneurysm, followed by omental flap coverage is a viable
strategy to manage mycotic aortic infections with virulent organisms.