Infected Abdominal Aortic Aneurysm Attributable to Haemophilus influenzae: Rapid Changes of Imaging Findings.

A 57-year-old man presented to the emergency department with an 8-day history of abdominal and suprapubic pain radiating in the back associated with fever (38.6°C), myalgia, and a painful rectal examination. A treatment with ofloxacin had been prescribed for a suspected prostatitis. His past medical history included overweight and current cigarette smoking (30 pack-year). Clinical examination found a tense and nondepressible abdomen without nausea or vomiting. On auscultation, he had an abdominal vascular murmur. Computed tomography angiography performed on day 1 revealed a moderate aneurysmal dilation of the infrarenal abdominal aorta with a maximal diameter of 25 mm along with a thickened wall, a periaortic infiltration, and thrombus (Figure 1A). Biological investigations revealed an elevated leukocyte count (14 780/mm3 with 92.5% neutrophils) and a high C-reactive protein level (256.4 mg/L), but no serological evidence for syphilis, HIV, hepatitis B or C infections, and negative standard bacterial and mycobacterial blood cultures. The persistence of abdominal pain and biological inflammation led to that performance of a new computed tomography angiography on day 4. It …