Management of Mycotic Abdominal Aortic Aneurysm Caused by Levofloxacin- and Ampicillin-Resistant Campylobacter fetus With Synthetic Vascular Graft Replacement Surgery and Long-Term Minocycline Therapy.

Mycotic aortic aneurysms caused by Campylobacter fetus (C. fetus) are rare, and the optimal regimens and duration of antimicrobial therapy remain unclear. We present a case of a man in his 70s with hypertension and chronic heavy alcohol consumption who presented with an eight-day history of persistent fever. Contrast-enhanced computed tomography of the abdomen and pelvis revealed a mycotic infrarenal aortic aneurysm. Empiric ceftriaxone and vancomycin were switched to minocycline after cultures identified levofloxacin- and ampicillin-resistant, but minocycline-susceptible C. fetus. The patient underwent synthetic graft replacement surgery on day 8 and completed 16 weeks of postoperative minocycline, achieving full recovery and showing no recurrence at a three-year follow-up. This case highlights the importance of early surgical intervention combined with long-term, targeted antimicrobial therapy for managing C. fetus-related mycotic aneurysms.