Infect Chemother.  2005 Oct;37(5):292-297.

A Case of Aorto-femoral bypass Graft Infection Complicated with Infective Endocarditis

• Jung DS
• Mun SH
• Choi SW
• Lee CJ
• Kim KT
• Paik JH
• Jeong YJ
• Cho KJ
• Kang DY
• Lee H

Abstract

Prosthetic vascular graft infection (PVGI) is a relatively uncommon complication of peripheral vascular surgery and although rare, is the most severe complication in reconstructive vascular surgery. The early diagnosis of this complication can reduce the mortality. We report a case of aorto-femoral bypass graft infection, which was diagnosed by Tc-99m HMPAO WBC scan, complicated with infective endocarditis. A 60-year-old man had been operated with aortofemoral bypass graft because of aortojejunal fistula due to abdominal aortic aneurysm. Nine months later, he was admitted with fever of two months' duration. On echocardiolography, aortic regurgitation and vegetation were observed, and then he was diagosed with infective endocarditis. He was treated with antibiotics for 6 weeks. Recurrent bacteremia of unknown origin persisted despite antibiotic therapy. Multiple microorganisms were separately isolated from the blood cultures. He complained of intermittent right groin pain. Imaging study (CT, MRI, US) showed no definite evidence of graft infection. However, Tc-99m HMPAO WBC scan demonstrated uptake in the aortofemoral bypass graft site. The patient underwent emergent aortofemoral graft removal with axillobifemoral bypass and right femoropopliteal bypass.

Keyword

Prosthetic graft infection; Infective endocarditis; Tc-99m HMPAO WBC scan

MeSH Terms

Anti-Bacterial Agents
Aortic Aneurysm, Abdominal
Aortic Valve Insufficiency
Bacteremia
Early Diagnosis
Endocarditis*
Fever
Fistula
Groin
Humans
Magnetic Resonance Imaging
Middle Aged
Mortality
Technetium Tc 99m Exametazime
Transplants*
Anti-Bacterial Agents
Technetium Tc 99m Exametazime