Mycotic Aneurysm of the Ascending Aorta Secondary to Serratia Infection: Differentiation from Prosthetic Valve Endocarditis

Twenty-one months after prosthetic aortic and mitral valve replacement, a 64-year-old man developed bacteremia secondary to a Serratia infection. Intensive investigatimi failed to reveal the origin of infection and gentamicin therapy did not eradicate the organisms from the bloodstream. The patient died. Postmortem examination revealed a large mycotic aneurysm arising from the aortotomy site but no evidence of prosthetic valve endocarditis. Late occurring bacteremia following valve replacement is discussed. Aortography may be necessary to delineate this problem.