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Aortoduodenal Fistula Associated with Streptococcus milleri Bacteremia and a Mitral Valve Vegetation

A Case Report

Department of Internal Medicine D, Rambam Medical Center

Yishai Levy

Department of Internal Medicine D, Rambam Medical Center

Arie Markel

Department of Internal Medicine D, Rambam Medical Center

Shlomo Torem

Vascular Surgery Unit, Rambam Medical Center, Haifa, Israel

J. Gerald Brook

Department of Internal Medicine D, Rambam Medical Center

A sixty-five-year-old woman was admitted to the hospital complaining of weight loss and melena. She had a history of five vascular operations including aortobifemoral bypass. During hospitalization, she developed sepsis with Streptococcus milleri bacteremia. A computed tomographic scan and gastroduodenoscopy suggested aortoduodenal fistula, which was confirmed by surgical exploration. An echocardiogram showed mitral valve vegetation. This case suggests the potential role of Streptococcus milleri bacteremia and endocarditis in the pathogenesis of aortoduodenal fistula.

Vascular and Endovascular Surgery, Vol. 28, No. 8, 571-575 (1994)
DOI: 10.1177/153857449402800810


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