| Rupture of a Popliteal Aneurysm
Associated with Klebsiella pneumoniae Infection |
iDepartment of Emergency Medicine and Department
of Cardiovascular Surgery*, Jichi Medical School, Tochigi, Japan)
| Mitsunobu Asato |
Nobuyuki Hasegawa |
Masayuki Suzukawa |
| Shinichi Ohki* |
Osamu Kamisawa* |
Katsuo Fuse* |
|
A 74-year-old man with pain and
swelling of the left thigh was transferred from another hospital
for further investigation. On admission, a diagnosis of a left
femoral vein thrombosis was made and he continued on anticoagulant
therapy. However, three and a half hours after admission he suddenly
developed hypotensive shock and became unconscious. Rupture of
a peripheral aneurysm was suspected in view of a rapid fall in
the hematocrit and the images of vascular echography. Rupture
of a left popliteal aneurysm was specifically diagnosed following
intra-arterial digital subtraction angiography. An emergency
aneurysmectomy and vascular reconstruction using the great saphenous
vein was performed. Interestingly, Klebsiella pneumoniae
was cultured from both the wall of the left popliteal artery
and the wound. Antibiotic therapy was therefore changed to flomoxef
(FMOX) on the 5th postoperative day (POD 5) and treatment continued
for a total of 6 weeks in accordance with the therapy of infectious
endocarditis. He returned to the previous hospital on POD 61.
@Jpn. J. Cardiovasc. Surg. 32F45-47 (2003) |
|
