Successful endovascular repair of a chronic Q fever-associated abdominal aortic infected aneurysm

Mycotic abdominal aortic aneurysm caused by <i>Coxiella burnetii</i> infection is rare and can be difficult to diagnose. The use of endovascular repair in mycotic abdominal aortic aneurysms is a controversial topic and its use to treat aneurysms specific to <i>Coxeilla</i> infection was rarely reported. We report a case of a 63-year-old man who had a suspicious travel and contact history and presented with persistent lumbar pain for more than 1 year without a proper diagnosis. Imaging revealed a large saccular infrarenal aortic aneurysm with surrounding stranding, L3 vertebral osteomyelitis, and psoas inflammation. The diagnosis of chronic <i>C burnetii</i> infection was confirmed by serological tests. Endovascular repair was performed successfully. Long-term antibiotics with doxycycline and hydroxychloroquine was prescribed. The patient was well for more than 3 years after surgery. Surveillance computed tomography scan showed shrinkage of aneurysm with no endoleak. There was no evidence of stent graft infection.