Descending Thoracic Aortic Aneurysm due to Brucella melitensis

• Main Authors: Mohammed Alsheef, Saud Alsaleh, Nahar Alanezi, Nizar Bakhsh, Rana AlDosary, Lina AlSharif, Arshad Mian, Azeem Ahsan, Isamme AlFayyad
• Format: Article
• Language: English
• Published: Hindawi Limited 2019-01-01
• Series: Case Reports in Infectious Diseases
• Online Access: http://dx.doi.org/10.1155/2019/4939452

Brucellosis is an endemic infection mainly in the Middle East and the Mediterranean region that can involve any system. However, cardiovascular involvement commonly seen as endocarditis is a rare occurrence, but it is one of the main causes of mortality and morbidity. Brucella mycotic aneurysms are extremely rare and carry a higher morbidity and mortality. Here, we present a case of Brucella mycotic aneurysms in the descending aorta complicated by an aortoesophageal fistula in a 52-year-old diabetic man. The diagnosis was made by thoracic CT angiogram showing a saccular aneurysm arising from the descending aorta and two positive cultures of Brucella melitensis. Transthoracic and transesophageal echocardiograms ruled out infective endocarditis. Aortoesophageal fistula complicating a Brucella mycotic aneurysm in the absence of evidence of endocarditis has not yet been reported in the literature.