Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 20, Number 11—November 2014

Helicobacter cinaedi Infection of Abdominal Aortic Aneurysm, Japan

Risako KakutaComments to Author , Hisakazu Yano, Hajime Kanamori, Takuya Shimizu, Yoshiaki Gu, Masumitsu Hatta, Tetsuji Aoyagi, Shiro Endo, Shinya Inomata, Chihiro Oe, Koichi Tokuda, Daiki Ozawa, Hitoshi Goto, Yukio Katori, and Mitsuo Kaku
Author affiliations: Tohoku University Graduate School of Medicine, Sendai, Japan

Main Article


Clinical characteristics of 3 patients with Helicobacter cinaedi–infected abdominal aortic aneurysms and molecular characteristics of isolates, Japan *

Characteristic Case-patient 1 Case-patient 2 Case-patient 3
Age, y/sex 64/M 59/M 62/M
Underlying diseases Hypertension, hyperlipidemia None History of myocardial infarction
Risk factors for infection None None None
Clinical signs and symptoms before surgery
Fever, back pain
Fever, abdominal pain
Low back pain
CT results
Site of aneurysm Infrarenal abdominal, bilateral common iliac, internal iliac, L femoral, aortic arch† Infrarenal abdominal, bilateral common iliac Infrarenal abdominal
Inflammatory findings around 
Maximum leukocyte count/μL)/C-reactive protein, mg/dL before operation 10,600/25.3 9,100/6.05 7,050/ 5.29
Surgical management
In situ grafting
In situ grafting
In situ grafting
Microbiological diagnosis
Blood culture
Tissue culture +‡
rRNA gene sequence similarity, %§
             16S 99.8 99.6 99.6
             23S 99.8 99.8 99.8
Amplification of gyrB specific to 
H. cinaedi + + +
Aneurysms in which H. cinaediwas identified
Infrarenal abdominal, L common iliac, R internal iliac, L femoral
Infrarenal abdominal
Infrarenal abdominal
MLST ST15 (CC7) ST10 (CC9) ST10 (CC9)
Mutation of 23S rRNA gene and amino acid substitutions in GyrA
2018 A→G and T84I D88G
2018 A→G and T84I
2018 A→G and T84I
Antimicrobial therapy dosage and duration
Before admission Ceftriaxone, 2 g/d, and levofloxacin, 500 mg/d, for 2 d Piperacillin/tazobactam, 4.5 g/d for 12 d; faropenem sodium hydrate, 600 mg/d for 10 d Oral antimicrobial agent, 4 d
After admission Doripenem, 1.5 g/d for 22 d, and vancomycin, 3.0 g/d, for 14 d Piperacillin/tazobactam, 4.5 g/d for 28 d Doripenem, 1.5 g/d for 28 d
After identification of pathogen Sulbactam/ampicillin, 3.0 g/d, and minocycline, 100 mg/d for 25 d Continuation of piperacillin/tazobactam Continuation of doripenem
At discharge
Oral amoxicillin, 1,500 mg/d, and minocycline, 200 mg/d, until follow-up visit
Oral amoxicillin, 1,500 mg/d, and minocycline, 200 mg/d, until follow-up visit
Oral amoxicillin, 1,500 mg/d, and minocycline, 200 mg/d, until follow-up visit
Postoperative complications None None None
Outcome Survived Survived Survived

*CT, computed tomography; +, positive; –, negative; L, left; R, right; MLST, multilocus sequence typing; ST, sequence type; CC, clonal complex; A, adenine; G, guanine; T, threonine; I, isoleucine; D, aspartic acid; G, glycine.
†Aortic arch was replaced 5 weeks after the abdominal operation.
‡Species unidentifiable under microaerophilic conditions.
§Compared with the type strain of H. cinaedi (CCUG 18818).

Main Article

Page created: October 20, 2014
Page updated: October 20, 2014
Page reviewed: October 20, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.