Infected aortic aneurysm caused by Helicobacter cinaedi: case series and systematic review of the literature

BMC Infect Dis. 2020 Nov 17;20(1):854. doi: 10.1186/s12879-020-05582-7.

Abstract

Background: Helicobacter cinaedi is rarely identified as a cause of infected aneurysms; however, the number of reported cases has been increasing over several decades, especially in Japan. We report three cases of aortic aneurysm infected by H. cinaedi that were successfully treated using meropenem plus surgical stent graft replacement or intravascular stenting. Furthermore, we performed a systematic review of the literature regarding aortic aneurysm infected by H. cinaedi.

Case presentation: We present three rare cases of infected aneurysm caused by H. cinaedi in adults. Blood and tissue cultures and 16S rRNA gene sequencing were used for diagnosis. Two patients underwent urgent surgical stent graft replacement, and the other patient underwent intravascular stenting. All three cases were treated successfully with intravenous meropenem for 4 to 6 weeks.

Conclusions: These cases suggest that although aneurysms infected by H. cinaedi are rare, clinicians should be aware of H. cinaedi as a potential causative pathogen, even in immunocompetent patients. Prolonged incubation periods for blood cultures are necessary for the accurate detection of H. cinaedi.

Keywords: Case report; Helicobacter cinaedi; Infected aneurysm; Japan.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Infected / diagnosis*
  • Aneurysm, Infected / drug therapy
  • Aneurysm, Infected / microbiology
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Aneurysm / diagnostic imaging*
  • Aortic Aneurysm / microbiology
  • Blood Culture
  • Female
  • Follow-Up Studies
  • Helicobacter / genetics*
  • Helicobacter / isolation & purification*
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / microbiology
  • Humans
  • Immunocompromised Host
  • Japan
  • Male
  • Middle Aged
  • RNA, Ribosomal, 16S / genetics
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • beta-Lactams / therapeutic use

Substances

  • Anti-Bacterial Agents
  • RNA, Ribosomal, 16S
  • beta-Lactams
  • fropenem

Supplementary concepts

  • Helicobacter cinaedi