Pneumococcal urinary antigen test: A tool for pneumococcal aortitis diagnosis?

• Main Authors: Stanislas Abrard, Benoit Cousin, Thomas Reydel, Myriam Ammi, Laurent Beydon
• Format: Article
• Language: English
• Published: Elsevier 2018-01-01
• Series: IDCases
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214250918300647

Introduction: Aortitis is rare. The etiological diagnosis is difficult but essential for treatment. Even with appropriate treatment mortality remains high. We present a case of pneumococcal aortitis followed by a brief review of the literature. Presentation of Case: In this case, the aortic disease was characterized by multiple inflammatory aneurysms. Blood cultures were negative but urine was tested for the presence of pneumococcal urinary antigen postoperatively was positive. Treatment consisted of antibacterial therapy and both surgical and endovascular procedures. The patient was discharged and is well. Discussion: Preoperative determination of etiology is crucial in implementing a specific treatment. Pneumococcus is a common bacterium in infectious aortitis. Identification of the causative microbe is necessary to guide antimicrobial therapy. Blood cultures are frequently sterile. The pneumococcal urinary antigen test may be more sensitive than blood cultures, as is the case in pneumococcal pneumonia. Conclusions: The pneumococcal urinary antigen test may was a useful diagnostic tool in establishing the cause for aortitis in this case. Its potential value should be assessed in furthers studies. Keywords: Aortitis, Aneurysm infected, Diagnosis, Streptococcus pneumoniae, Pneumococcal infections