Streptococcus constellatus Causing Mycotic Aneurysm in A Patient with Diffuse Large B-Cell Lymphoma

Nadeem Sajjad Raja¹, Albena Nikolova², Theo Raudsepp³, Simon G Weston-Smith², Annette Rumbold², Hizbullah Shaikh⁴, Sunil Gupta²

¹Department of Microbiology, East Sussex Healthcare Trust, Hastings, United Kingdom

²Department of Clinical Haematology, East Sussex Healthcare Trust, Hastings, United Kingdom

³Department of Radiology, East Sussex Healthcare Trust, Hastings, United Kingdom

⁴Department of Histopathology , Kings College Hospital, London, United Kingdom

ABSTRACT

This is a first case of mycotic aneurysm due to Streptococcus constellatus in a 58 years old male patient with diffuse large B cell lymphoma. A mycotic aneurysm is a rare but life threatening and potentially fatal sequela of bacteraemia. A 58-year male patient initially presented with sepsis after 7 days of chemotherapy. No clear focus of sepsis was found. Blood culture grew Streptococcus constellatus. He received appropriate antibiotic and discharged well. He represented after 5 days with excruciating intrascapular and chest pain. This patient with haematology malignancy had radiologically, surgically and histologically confirmed mycotic aneurysm that involved ascending aorta which contained pseudoaneurysm. Patient was treated excision of the infected tissue and aortic graft, and long term antibiotics. This rare case highlights that the high clinical suspicion in patients presenting with possibly mycotic aneurysm is a critical tool in addition to perfect surgical treatment and medical treatment with adequate antibiotics. J Microbiol Infect Dis 2017; 7(4):213-216

Keywords: Mycotic aneurysm, blood stream infections, cancer, diffuse large B cell lymphoma