{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:20:24Z","timestamp":1793996424537,"version":"4.8.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270518"],"award-info":[{"award-number":["82270518"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2022MH031"],"award-info":[{"award-number":["ZR2022MH031"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The occurrence of Brucella-induced abdominal aortic aneurysms is an exceedingly rare phenomenon, yet it stands as one of the most severe complications within this context. The combined utilization of serological testing and imaging diagnostics has been validated as an effective approach for the identification of Brucella-induced abdominal aortic aneurysms. Presently, the predominant therapeutic strategies encompass antibiotic treatment and surgical intervention. Nonetheless, ongoing controversies persist concerning the establishment of diagnostic criteria, the optimal timing and selection of antibiotic regimens, and the nuanced decision between open surgical procedures and endovascular interventions. Through a meticulous analysis of cases originating from our institution as well as a comprehensive review of previously documented instances, we aim to engage in a detailed discourse on the salient diagnostic and therapeutic facets surrounding Brucella-induced abdominal aortic aneurysms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective summary of three cases involving Brucella-induced abdominal aortic aneurysms treated within our institution. Furthermore, we performed a comprehensive PubMed search, without imposing restrictions on language or publication year, to identify pertinent literature pertaining to Brucella-induced abdominal aortic aneurysms. The selection criteria primarily focused on case reports delineating occurrences of abdominal aortic aneurysms attributed to Brucella infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We present three distinct cases of Brucella-induced abdominal aortic aneurysms managed at our institution, providing comprehensive insights into the employed diagnostic and therapeutic approaches. Additionally, over the past five decades, a total of 24 cases in 23 publications of Brucella-induced abdominal aortic aneurysms have been reported on PubMed. The earliest report dates back to 1976.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our analysis suggests that Brucella-induced abdominal aortic aneurysm is characterized by a remarkably low incidence but is associated with a substantial risk of life-threatening complications. The integration of serological and imaging assessments assumes pivotal importance in facilitating prompt diagnosis of this condition. The prompt initiation of targeted antibiotic therapy is recommended, and the selection of appropriate surgical strategies should be guided by considerations including aneurysm dimensions and morphological attributes. The timely identification and intervention carry utmost significance in retarding disease advancement and ameliorating unfavorable clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1271217","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T16:38:37Z","timestamp":1698943117000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Brucella-infected abdominal aortic aneurysm: management strategies for an uncommon 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O:9","volume":"35","author":"La Scola","year":"1997","journal-title":"J Infect"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"483","DOI":"10.3109\/00365548709021683","article-title":"Infective aortitis due to Brucella melitensis","volume":"19","author":"Aguado","year":"1987","journal-title":"Scand J Infect Dis"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1007\/BF02007004","article-title":"False aneurysm of the abdominal aorta due to Brucella suis","volume":"6","author":"Bergeron","year":"1992","journal-title":"Ann Vasc Surg"},{"key":"ref40","first-page":"2083","article-title":"Brucella aneurysm of abdominal aorta","volume":"5","author":"Gillet","year":"1976","journal-title":"Nouv Press Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e00903","DOI":"10.1128\/JCM.00903-20","article-title":"Improved early detection of focal brucellosis complications with anti-brucella 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retrospective study of 98 cases. French University Association for Research in surgery","volume":"6","author":"Bacourt","year":"1992","journal-title":"Ann Vasc Surg"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"3035","DOI":"10.1007\/s00268-018-4533-x","article-title":"The results of in situ prosthetic graft replacement for infected aortic disease","volume":"42","author":"Han","year":"2018","journal-title":"World J Surg"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1161\/CIRCULATIONAHA.114.009481","article-title":"Endovascular treatment of mycotic aortic aneurysms: a European multicenter study","volume":"130","author":"Sorelius","year":"2014","journal-title":"Circulation"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.jvs.2019.09.060","article-title":"Dutch Society of Vascular Surgery tSCotDSAA, the Dutch Institute for Clinical A. Nationwide study of the treatment of mycotic abdominal aortic aneurysms comparing open and endovascular repair in the Netherlands","volume":"72","author":"Dang","year":"2020","journal-title":"J Vasc Surg"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1016\/j.jvs.2007.07.025","article-title":"Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review","volume":"46","author":"Kan","year":"2007","journal-title":"J Vasc Surg"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1053\/j.semvascsurg.2017.11.002","article-title":"How to best treat infectious complications of open and endovascular thoracic aortic repairs","volume":"30","author":"Kahlberg","year":"2017","journal-title":"Semin Vasc Surg"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.2174\/1874467214666210210122628","article-title":"Minocycline and doxycycline: more than antibiotics","volume":"14","author":"Singh","year":"2021","journal-title":"Curr Mol Pharmacol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s10856-018-6117-6","article-title":"Characterization of doxycycline-loaded calcium phosphate cement: implications for treatment of aneurysmal bone cysts","volume":"29","author":"Daley","year":"2018","journal-title":"J Mater Sci Mater Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.jvs.2022.01.079","article-title":"Longer follow-up intervals following endovascular aortic aneurysm repair are safe and appropriate after marked aneurysm sac regression","volume":"76","author":"Andraska","year":"2022","journal-title":"J Vasc Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1271217\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T16:38:40Z","timestamp":1698943120000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1271217\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":52,"alternative-id":["10.3389\/fmed.2023.1271217"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1271217","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,2]]},"article-number":"1271217"}}