Infective thoracic aortic aneurysm caused by Clostridium difficile after endovascular aortic repair

Clostridioides difficile from intracardiac vegetation

Extracolonic manifestations by Clostridioides difficile are uncommon. Here, we report a case of monomicrobial C. difficile intracardiac vegetation in a 11-year-old girl with a predisposed heart disease who responded well to the treatment. C. difficile has been isolated from a variety of specimens outside the intestinal tract and is not always associated with gastrointestinal symptoms.

Clostridioides (Clostridium) difficile Pacemaker Infection

Clostridioides difficile is the leading cause of antibiotic-associated nosocomial diarrhea, but extra-intestinal manifestations are rare. We describe the first documented case of bacteraemia with pacemaker pocket and lead infection with the toxigenic C. difficile ribotype 014 with a lack of abdominal symptoms. The patient underwent pacemaker extraction and treatment with intravenous and oral vancomycin. Genotyping and molecular subtyping revealed clonality between pacemaker and intestinal isolates. This case illustrates the risk of intravascular device infections due to C. difficile. Even asymptomatic C. difficile colonization might pose a risk for prosthetic material infection.

Infected thoracic aortic aneurysm caused by Clostridium ramosum: A case report

A 73-year-old man undergoing conservative management of acute aortic dissection (Stanford type B) was diagnosed with infected aortic aneurysm based on clinical findings of aortic dilatation and recurrent laryngeal nerve paralysis. We performed total aortic arch replacement with a synthetic graft and omentopexy; and Clostridium ramosum was isolated from resection specimens. Infected aortic aneurysms are rare but may lead to death from aortic dissection or rupture. C. ramosum infection is rare and has seldom been reported, and thus no treatment guidelines, including antibiotic therapy, have been established. Therefore, it is necessary to accumulate a larger number of cases of aortic aneurysm infected by C. ramosum. To date, there has been no reported case of infected aortic aneurysm due to C. ramosum. Here, we report a case of infected aortic aneurysm due to C. ramosum. <Learning objective: Infected aortic aneurysm is a life-threatening condition because of the possibility of aortic dissection and rupture. Infected aortic aneurysms are often caused by Staphylococcus aureus and Salmonella species, and there has been no report of aortic aneurysm infected by C. ramosum. Regarded as a non-pathogenic intestinal bacterium, C. ramosum is seldom identified as a causative bacterium. In this case, dilatation of aorta progressed rapidly, requiring early surgical treatment.>.