José A. Sabalza, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Roberto Tipón, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Wilfrido Coronel, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Anderson Londoño, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Neylor Chalabe, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Carlos García, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Alejandra Vergara, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Juan C. Jaramillo-González, Departamento de Cirugía Cardiovascular, Clínica El Rosario, Medellín, Colombia
Omar Castilla, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Antonio Oyola, Unidad de Cuidados Intensivos Cardiovascular, Clínica Neurocardiovascular Neurodinamia, Cartagena, Colombia
Aortic graft infection is a rare entity that is difficult to diagnose, especially when conventional studies are inconclusive. The aim of this report is to describe a case of aortic prosthetic infection presenting as systemic embolic syndrome, to highlight the value of PET-CT in its diagnosis, and to discuss management options. A 68-year-old male patient with a history of ascending aorta reconstruction with a Dacron graft presented with recurrent bacteremia due to VIM carbapenemase-producing Pseudomonas aeruginosa, embolic skin lesions, multifocal cerebral infarcts, and a splenic lesion. Conventional studies were inconclusive. A cardiac MRI revealed a mobile filamentous image at the graft anastomosis. A PET-CT showed hypermetabolism in the ascending aortic prosthesis (SUVmax 6.58), confirming active infection. Conservative management with oral ciprofloxacin for six weeks was chosen given the patient’s high surgical risk, with favorable clinical evolution and no readmissions at two months. PET-CT is a key diagnostic tool when conventional studies are negative, and prolonged antibiotic therapy may be a valid alternative in selected patients with high surgical risk.
Keywords: Aortic graft infection. PET-CT. Systemic embolism. Pseudomonas aeruginosa. Vascular prosthesis. Bacteremia.
