Helicobacter cinaedi as a cause of primary aortic infections and the challenges of diagnosis and optimal treatment

Helicobacter cinaedi is primarily seen and diagnosed in immunocompromised patients. We present cases of primary mycotic aortitis in three immunocompetent and one immunocompromised patient caused by H cinaedi. Bacterial identification was made through perioperative samples using 16S rRNA gene sequencing, as routine culture techniques were negative owing to the slow turnaround time of H cinaedi. Successful management was achieved with a neoaortoiliac system and prolonged intravenous antibiotic therapy. All four patients had a history of having sex with men, highlighting the need to further investigate the transmission of H cinaedi in immunocompetent patients and its association with aortitis.