Mycotic thromboaneurysmal disease of the abdominal aorta in preterm infants: Its natural history and its management

Thom E. Lobe, Carol Richardson, Thomas F. Boulden, Leonard E. Swischuk, C. Keith Hayden, Keith T. Oldham

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28 Scopus citations

Abstract

Five infants with mycotic complications of umbilical artery catherization were evaluated with abdominal ultrasound and followed serially to document their natural history. Methicillin-resistant Staphylococcus aureus was always the infecting organism. There were one female and four male infants and they weighed between 900 and 1,200 g at birth. While two of the catheters were positioned in the abdominal aorta, three were located above the diaphragm. The predominate signs and symptoms included: thrombocytopenia, unexplained anemia, renal failure, hypertension, and embolic phenomena to the toes. Real-time ultrasound always proved sufficient for diagnosis. Serial studies detected the initial aortic thrombosis in three patients and accurately documented its progression to aneurysmal disease over 10 days in one patient and 17 days in another. Three of the infants were diagnosed with aneurysms at their initial examination. Of the five patients, three were treated nonoperatively and died of complications of their aortic disease. One patient was discovered at operation to have necrotic ischemic intestine. Aortic repair was postponed and he died of septic complications. The remaining patient underwent a PTFE interposition graft and survived for 6 months, dying of pulmonary failure with autopsy confirmed graft patency.

Original languageEnglish (US)
Pages (from-to)1054-1060
Number of pages7
JournalJournal of Pediatric Surgery
Volume27
Issue number8
DOIs
StatePublished - 1992

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Keywords

  • aortic thrombosis
  • Mycotic aneurysm
  • umbilical artery catherization, complications

ASJC Scopus subject areas

  • Surgery

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