The University of Toledo Translation Journal of Medical Sciences 
Infectious Diseases Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Streptococcal Pneumoniae Mycotic 
Aneurysm: A Rare Case of Disseminated 
Pneumococcal Disease in an 
Immunocompetent Host 
Victoria Starnes, M31*, Rebecca Asher, M31, Caitlyn Hollingshead, MD1 

1Division of Infectious Diseases, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 

*Corresponding author: Victoria.starnes@rockets.utoledo.edu

Published: 05 May 2023 

Introduction: Mycotic abdominal aortic aneurysm (MAAA) is a rare infection of the aortic wall that 
may progress to aortic rupture. The most common infecting organisms are Staphylococcus and 
Salmonella species. Clinical characteristics are diverse and depend on the source of the infection. We 
present a case of mycotic AAA caused by Streptococcus pneumoniae without an apparent source of 
infection.   

Case Presentation: A man in his sixties presented to the hospital with a three-day history of low back 
pain, chills, and rigors. CT revealed a ruptured AAA measuring 5.3 cm with stranding and multiple 
prominent adjacent lymph nodes. MRI lumbar spine showed prevertebral edema. AAA repair was 
performed with a rifampin-soaked tube. Cultures taken from the aneurysm revealed S. pneumoniae. He 
was treated with intravenous beta-lactam therapy for six weeks, followed by one year of amoxicillin for 
suppression. Pneumococcal vaccine was recommended to prevent future infections.   

Discussion: S. pneumoniae makes up approximately 8% of all bacterial abdominal aortic aneurysms. 
Common symptoms include abdominal and back pain, pulsating mass, fever, and sepsis. Diagnosis is 
suggested by findings of lymphadenopathy on imaging and confirmed with positive surgical cultures. 
The use of antimicrobial therapy and surgery are essential for management. Pneumococcal vaccination is 
underutilized as defense against invasive disease. Disseminated pneumococcal disease in an 
immunocompetent host is a rare phenomenon in recent years due to vaccination, with review of the 
literature revealing only one similar reported case. Our case highlights the importance of vaccinations in 
preventing disseminated infection in even the healthiest of patients. 

https://dx.doi.org/10.46570/utjms.vol11-2023-761 

https://dx.doi.org/10.46570/utjms.vol11-2023-761
mailto:Victoria.starnes@rockets.utoledo.edu