Continued Lumbar Spinal Erosion after Repair of Chronic Contained Rupture of a Mycotic Abdominal Aortic Aneurysm

Abstract

Mycotic aneurysm of the aorta is a rare, dangerous condition. We report a case of an abdominal aortic aneurysm (AAA) caused by Candida albicans. Case report and review of pertinent English-language literature. A 48 year-old man presented with an acute exacerbation of long-standing back pain. Examination revealed a pulsatile epigastric mass, and radiologic examinations confirmed a 9 cm chronic contained rupture of an inflammatory infrarenal AAA. At operation, no posterior aneurysm sac was found, and lumbar vertebral erosion was noted. Lower limb vascularity was secured with left axillo-bifemoral bypass. The patient presented 12 months later with severe non-mechanical back pain. Imaging confirmed continuing vertebral erosion. At laparotomy, an autologous fibula strut was used for spinal stabilization. Aggressive multimodality therapy of infected AAA and associated vertebral osteomyelitis is necessary for a successful outcome.