Mycotic abdominal aortic aneurysm in a patient with rheumatic heart disease: A case report

ABSTRACT

@#Rheumatic heart disease is one of the most common acquired heart diseases with valvular heart damage as its hallmark. It is preventable, and the prognosis is good when caught early on. However, serious complications could arise if early detection and prompt intervention are not done. One of its dreaded complication is mycotic abdominal aortic aneurysm, an uncommon sequela that could arise from infective endocarditis. In such cases, surgical intervention is warranted due to its high risk of rupture. The case presented is a 9-year-old female with rheumatic heart disease and infective endocarditis who later developed mycotic abdominal aortic aneurysm. Manifestations were fever, joint pains, left-sided body weakness and abdominal mass. Echocardiography revealed mild aortic insufficiency with vegetations. Abdominal CT scan and CT angiogram showed a mass in the left para-aortic region and a saccular abdominal aneurysm, respectively, which confirmed the diagnosis. Antibiotics and cardiac support were given, and eventually underwent repair of aneurysm with mitral valve replacement. The aim of presenting this report is to highlight one of the rarest complications of rheumatic heart disease and infective endocarditis - mycotic abdominal aortic aneurysm.