Mycotic thromboaneurysmal disease of the abdominal aorta in preterm infants

Its natural history and its management

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

Research output: Contribution to journalArticle

28 Citations (Scopus)

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 - Jan 1 1992

Fingerprint

Abdominal Aorta
Natural History
Premature Infants
Transplants
Aortic Diseases
Umbilical Arteries
Renal Hypertension
Polytetrafluoroethylene
Toes
Methicillin-Resistant Staphylococcus aureus
Diaphragm
Thrombocytopenia
Signs and Symptoms
Intestines
Renal Insufficiency
Aneurysm
Anemia
Autopsy
Thrombosis
Catheters

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Mycotic thromboaneurysmal disease of the abdominal aorta in preterm infants : Its natural history and its management. / Lobe, Thom E.; Joan Richardson, C.; Boulden, Thomas; Swischuk, Leonard E.; Keith Hayden, C.; Oldham, Keith T.

In: Journal of Pediatric Surgery, Vol. 27, No. 8, 01.01.1992, p. 1054-1060.

Research output: Contribution to journalArticle

Lobe, Thom E. ; Joan Richardson, C. ; Boulden, Thomas ; Swischuk, Leonard E. ; Keith Hayden, C. ; Oldham, Keith T. / Mycotic thromboaneurysmal disease of the abdominal aorta in preterm infants : Its natural history and its management. In: Journal of Pediatric Surgery. 1992 ; Vol. 27, No. 8. pp. 1054-1060.
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