First case of aorto‑bi‑iliac endograft thrombotic infection by <em>Listeria monocytogenes</em>: A case report

Zardi,Enrico M.; Montelione,Nunzio; Catanese,Vincenzo; Gabellini,Teresa; Caricato,Marco; Zardi,Domenico M.; Spinelli,Francesco; Stilo,Francesco

doi:10.3892/etm.2022.11416

First case of aorto‑bi‑iliac endograft thrombotic infection by Listeria monocytogenes: A case report

Authors:
- Enrico M. Zardi
- Nunzio Montelione
- Vincenzo Catanese
- Teresa Gabellini
- Marco Caricato
- Domenico M. Zardi
- Francesco Spinelli
- Francesco Stilo
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Affiliations: Internistic Ultrasound Service, ‘Campus Bio‑Medico’ University of Rome, I-00128 Rome, Italy, Division of Vascular Surgery, ‘Campus Bio‑Medico’ University of Rome, I-00128 Rome, Italy, Colorectal Surgery Unit, ‘Campus Bio‑Medico’ University of Rome, I-00128 Rome, Italy, Interventional Cardiology Unit, Castelli Hospital, I-00040 Ariccia, Italy
Published online on: June 6, 2022 https://doi.org/10.3892/etm.2022.11416
Article Number: 489

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Abstract

Listeria monocytogenes may cause serious vascular and graft infections. In the present case report, a 71‑year‑old man underwent partial prosthetic endograft replacement due to high‑flow endoleak and limb occlusion. Following surgery, a multiple empiric antibiotic regime was initiated due to fever, malaise, abdominal tenderness and signs of an acute abdomen; however, in spite of this, the clinical condition of the patient worsened. An aorto‑enteric fistula was discovered, and duodenal resection with duodeno‑jejunal anastomosis packaging was performed. Gastrointestinal bleeding originating from this anastomosis both complicated and prolonged the clinical course, necessitating appropriate parenteral support and endoscopic hemostasis. The growth of Candida lusitanae in the drained abdominal and pleural effusion, and the isolation of L. monocytogenes from the thrombus inside the removed abdominal aorto‑bi‑iliac endograft allowed for establishment of a specific antibiotic treatment. After a suitable period of clinical improvement, the patient was transferred to a clinical rehabilitation center. At the present time, the patient maintains a good condition. To the best of our knowledge, the present study represents the first described case of thrombotic infection of an aorto‑bi‑iliac endograft by L. monocytogenes. In the event of graft thrombotic occlusion, L. monocytogenes infection should be considered as a potential cause. In case of complications requiring open conversion, even if not suspected from the medical history of the patient, the possibility of an underlying and occult infection should always be excluded with an in‑depth preoperative work‑up.

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