Abdominal pain in a man with an endovascular aortic prosthesis

A 79-year-old man with an abdominal aorta aneurysm (AAA) with endovascular repair presented with abdominal pain and inflammation. Although the initial work-up was in favour of an idiopathic inflammatory AAA, FDG-PET imaging showed atypical irregular uptake. Per-operative assessment and culture of pus matter revealed infection by Listeria monocytogenes. Atypical findings on imaging of aortic wall inflammation should alarm the clinician of an infectious aetiology.