Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6529-6536
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6529
Successful endovascular treatment with long-term antibiotic therapy for infectious pseudoaneurysm due to Klebsiella pneumoniae: A case report
Tie-Hao Wang, Ji-Chun Zhao, Bin Huang, Jia-Rong Wang, Ding Yuan
Tie-Hao Wang, Ji-Chun Zhao, Bin Huang, Jia-Rong Wang, Ding Yuan, Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Author contributions: Wang TH, Zhao JC and Huang B performed the surgery and wrote the paper; Wang JR and Yuan D collected the information and followed the patient; Wang TH and Yuan D revised the paper; All authors read and approved the final manuscript.
Supported by Sichuan Foundation of Science and Technology, No. 2019YJ0066.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ding Yuan, MD, Assistant Professor, Department of Vascular Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu 610000, Sichuan Province, China. yuandingdoc09@163.com
Received: September 27, 2020
Peer-review started: September 25, 2020
First decision: October 18, 2020
Revised: October 22, 2020
Accepted: November 2, 2020
Article in press: November 2, 2020
Published online: December 26, 2020
Processing time: 83 Days and 9.8 Hours
Abstract
BACKGROUND

Infectious common femoral artery pseudoaneurysm caused by Klebsiella pulmonary infection is a relatively infrequent entity but is potentially life and limb threatening. The management of infectious pseudoaneurysm remains controversial.

CASE SUMMARY

We reported a 79-year-old man with previous Klebsiella pneumoniae pulmonary infection and multiple comorbidities who presented with a progressive pulsate mass at the right groin and with right lower limb pain. Computed tomography angiography showed a 6 cm × 6 cm × 9 cm pseudoaneurysm of the right common femoral artery accompanied by occlusion of the right superficial femoral artery and deep femoral artery. He underwent endovascular treatment (EVT) with stent–graft, and etiology of infectious pseudoaneurysm was confirmed. Then, 3-mo antibiotic therapy was given. One-year follow-up showed the stent–graft was patent and complete removal of surrounding hematoma.

CONCLUSION

The femoral artery pseudoaneurysm can be caused by Klebsiella pneumoniae deriving from the pulmonary infection. Moreover, this unusual case highlights the use of EVT and prolonged antibiotic therapy for infectious pseudoaneurysm.

Keywords: Infectious pseudoaneurysm; Common femoral artery; Klebsiella pneumoniae; Antibiotic therapy; Endovascular treatment; Case report

Core Tip: Infectious pseudoaneurysm of the femoral artery is a rare entity that is potentially life and limb threatening. Common femoral artery (CFA) pseudoaneurysm caused by Klebsiella pneumoniae has not been reported. We reported a rare infectious CFA pseudoaneurysm, which was caused by previous pulmonary infection of Klebsiella pneumoniae. After endovascular treatment (EVT) and long-term antibiotic therapy, the patient had a good result at the 1-year follow-up. This case demonstrates common femoral artery pseudoaneurysm can be caused by Klebsiella pneumoniae deriving from the pulmonary infection. Moreover, it highlights the use of EVT and prolonged antibiotic therapy for infectious pseudoaneurysm.