Acquired immunodeficiency syndrome and mycotic abdominal aortic aneurysms: A new challenge? Report of a case

Abstract

The case of a 64-year-old white man with acquired immunodeficiency syndrome and ruptured abdominal aortic aneurysm infected with Salmonella is presented. Five points related to this case are addressed. It is feared that the vascular surgeon may face patients with acquired immunodeficiency syndrome and abdominal aortic aneurysms infected with Salmonella with increasing frequency in the future. This case raises medical, ethical, and moral questions.

HIV-associated large-vessel vasculopathy: a review of the current and emerging clinicopathological spectrum in vascular surgical practice: review article

“…Since the first report of Salmonella-related mycotic aneurysmal disease by Du Pont et al 24 in an HIV-positive patient in 1989, increasing numbers of reports have emanated from Zimbabwe, Zambia and South Africa, 4 , 25 - 31 confirming the occurrence of aneurysmal disease independent of bacterial infection. These aneurysms are multiple, with a predilection for young individuals and atypical locations, including the aorta, carotid, popliteal and femoral vessels.…”

“…The literature pertaining to the diverse spectrum of HIV-associated large-vessel vasculopathy has been confined to case reports, 21 , 24 , 50 , 62 , 63 small patient series, 26 , 30 and larger studies 4 , 22 , 28 , 29 , 31 , 47 , 52 , 57 - 59 (Table 1) . The majority of caseloads have focused on clinical aspects of aneurysmal and occlusive disease that were observed mainly during the pre-HAART era, while, to date, the mechanisms underlying the pathological process remain theoretical without definitive isolation of an infective agent.…”

Arteriovenous fistula secondary to iliac mycotic aneurysm: helical CT findings

“…Other risk factors are more common now than in the past and include arterial trauma due to diagnostic or therapeutic arterial catheterization, intravenous drug abuse, immunosuppression secondary to either chronic or neoplastic diseases, acquired immune deficiency syndrome, chemotherapy treatment, autoimmune diseases, existing aneurysm or arterial graft, alcoholism, and diabetes mellitus [2,3,5,7,9]. The primary source of infection is found in only 50% of cases [5].…”

Successful Endovascular Treatment of A Ruptured Mycotic Intracavernous Carotid Artery Aneurysm in an AIDS Patient

“…An HIV-related aneurysm was first described in 1989 [12]. Since then, it has become increasingly clear that HIVrelated aneurysms generally fall into two categories: the mycotic aneurysms from bacterial or fungal infections, and the HIV-associated aneurysms that constitute a distinct clinical and pathological entity [13,14].…”