CT scan of the chest and abdomen revealed expansion of the descending thoracic aneurysm with what appeared to be a contained rupture that measures 12.6 cm in transverse dimension. There is a dissection flap with true and false lumens extending down to the level of the celiac axis. There is small bilateral pleural effusion.

Contained rupture of the descending thoracic aneurysm

false and true lumens of the descending aortic aneurysm with dissection

the celiac artery coming off from the true lumen

the splenic artery coming off from the false lumen of the dissection

Patient was taking to the operating room where a 22 mm hemashield graft was placed and the aneurysm was repaired. Gram stain of the surgical specimen of the aneurysm revealed comma-shaped organism and cultures were positive for campylobacter fetus subspecies fetus.

Upon further questioning of the patient, he stated that he slaughtered a dead buffalo and dissected him few weeks, and he has been feeling well since that time.

Submitted by Paul Carson, MD, FACP

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References

Klin Wochenschr: Campylobacter fetus subspecies fetus infection	Mii S, Tanaka K et al Mycotic aneurysm caused by Campylobacter fetus