Pneumococcal Aortitis

Infectious aortitis, often leading to mycotic aortic aneurysm, is an uncommon disease. It is usually caused by either Staphylococcus aureus or Salmonella species. Streptococcus pneumoniae is rarely reported as a cause of aortitis. We report a patient with infectious aortitis in which S. pneumoniae was isolated in blood and tissue cultures from emergent open surgical intervention. A review of the literature suggests that pneumococcal aortitis is an emerging infectious disease with many more cases reported during the last 2 decades than in the previous 50 years. Of the cases reported since 2008, only 9 of 28 patients had an associated source for pneumococcal disease (pneumonia, meningitis, or endocarditis). Physicians should include infectious aortitis in the differential diagnosis of patients with primary pneumococcal bacteremia (no initial defined source).