Infected abdominal aorta aneurysm secondary to streptococcal toxic shock syndrome due to Streptococcus pyogenes: a case report from Japan

We experienced the successful management of infected aortic aneurysms secondary to streptococcal toxic shock syndrome. The development of infected aortic aneurysms should be considered in the case of streptococcal toxic shock syndrome in patients having a medical history of aortic aneurysms. Background Infected aortic aneurysm secondary to streptococcal toxic shock syndrome caused by Streptococcus pyogenes is uncommon and associated with high mortality. Case presentation A 75‐year‐old man with metastatic lung cancer and an abdominal aortic aneurysm presented with high fever for 3 days. He was diagnosed with septic shock and was admitted to our hospital. The blood culture was positive for S. pyogenes, and streptococcal toxic shock syndrome was diagnosed. During treatment, enhanced computed tomography revealed an increase in the size of the abdominal aortic aneurysm, leading to the diagnosis of an infected aortic aneurysm. Replacement of the aneurysm with a synthetic graft was carried out successfully. The patient gradually recovered after the surgery. Conclusion We successfully managed an infected aortic aneurysm secondary to streptococcal toxic shock syndrome. Infected aortic aneurysms should be considered in patients with a medical history of aortic aneurysms and presenting with streptococcal toxic shock syndrome.