Latent mycobacterium avium infection causing a mycotic suprarenal aortic aneurysm in a human immunodeficiency virus-positive patient

Ann Vasc Surg. 2014 May;28(4):1035.e1-4. doi: 10.1016/j.avsg.2013.06.036. Epub 2013 Oct 27.

Abstract

Mycobacterium avium complex (MAC) infection occurs in up to 50% of advanced-stage human immunodeficiency 1 (HIV-1) infections when the CD4 counts is <50/mm³. We report the case of a 52-year-old HIV-positive patient who presented with a symptomatic, rapidly growing suprarenal abdominal aortic aneurysm. He had been diagnosed and treated for disseminated MAC infection 3 years earlier. He was treated with antiretroviral medications and had a CD4 count >250 cells/mm³ and an undetectable viral load. Open repair was performed using cryopreserved homograft. Microbiologic cultures from the specimen revealed infection with mycobacterium avium. This is the first case to report a mycotic suprarenal aortic aneurysm caused by an active conversion of a latent MAC infection.

Publication types

  • Case Reports

MeSH terms

  • Allografts
  • Aneurysm, Infected / diagnosis
  • Aneurysm, Infected / microbiology*
  • Aneurysm, Infected / surgery
  • Anti-Bacterial Agents / therapeutic use
  • Anti-HIV Agents / therapeutic use
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / microbiology*
  • Aortic Aneurysm, Abdominal / surgery
  • Aortography / methods
  • Bioprosthesis
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Coinfection*
  • Cryopreservation
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV-1 / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium avium Complex / isolation & purification*
  • Mycobacterium avium-intracellulare Infection / diagnosis
  • Mycobacterium avium-intracellulare Infection / drug therapy
  • Mycobacterium avium-intracellulare Infection / microbiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-HIV Agents