CTICasesInfected Aortic Endograft with Serratia Aortitis
Imaging findings
A 63-year-old man with a remote type B dissection repaired by endograft in 2011, and a history of IV drug use, presented unwell with bacteremia. CTA shows a rind of inflammation encasing the descending thoracic aorta at and beyond the graft, and abdominal CT shows a loculated fluid collection with peripheral enhancement and surrounding inflammation. Surgery found frank pus; cultures grew Serratia marcescens, and the aorta was replaced with a homograft.
Key takeaways
An infected aortic endograft (graft infection/aortitis) presents as a rind of periaortic inflammation and loculated peri-graft fluid with enhancement, particularly in patients with bacteremia and IV drug use. Serratia marcescens is a gram-negative rod known to cause endocarditis and aortitis in IV drug users, and homograft replacement is the surgical treatment, though the prognosis can be poor.
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