Mycotic aneurysm of the abdominal aorta.

Mycotic aneurysm of the abdominal aorta is an uncommon disease that carries a high mortality rate. In this report, two patients with this disease are presented. In the first case, Salmonella sp was cultured from an atherosclerotic aneurysm, and in the second patient, the aneurysm was a complication of Staphylococcus aureus bacterial endocarditis. Both presented suggestive clinical findings of the disease with fever, back pain, and pulsatile and expansive abdominal mass. The first patient was submitted to emergency aneurysmectomy with insertion of a dacron aorto-bi-iliac prosthesis and antibiotic therapy for a long period. He died two months after surgery due to upper gastrointestinal tract bleeding. The second patient was submitted to a successful and not yet described arterial reconstruction which included ligation of the aortic aneurysm and interposition of an aorto-bi-iliac sequential venous graft with reverse autologous saphenous vein. The authors consider this technique to be a good choice for the surgical treatment of mycotic aneurysm of the abdominal aorta particularly because it enables to avoid synthetic prosthesis.