Non-typhoidal Salmonella aortitis

Giannotti, G.; Zanotti, Paola; Pucci, Alessandro; Tomasoni, Lina Rachele; Caligaris, Silvio; Paro, Barbara; Gavazzi, Emanuele; Albano, Domenico; Bonardelli, Stefano; Maroldi, Roberto; Giubbini, Raffaele; Castelli, Francesco

doi:10.1007/s15010-019-01344-z

Cited by 11 publications

(10 citation statements)

References 13 publications

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“…4,6 Infectious causes are particularly rare, but early identification is critical given a mortality rate approaching 100% without surgical intervention. [1][2][3] Pathogens involved in infectious aortitis are Staphylococcus aureus (the most common,) non-typhoidal salmonella as seen in our patient, Streptococcus pneumonia, and group A streptococcus. Less common infectious causes include tuberculosis and syphilis.…”

Section: Discussionmentioning

confidence: 65%

“…5 Risk factors include male gender, age > 50, diabetes, recent history of invasive catheterization, vascular risk factors such as hypertension and atherosclerosis, particularly a history of known aortic atherosclerosis, coronary artery disease, immunodeficiency, and solid organ cancer. 1,3,5 Classic symptoms observed in cases of aortitis are fever as well as back and abdominal pain. 9 If there is an associated aneurysm, patients may have a pulsatile abdominal mass.…”

Section: Discussionmentioning

confidence: 99%

“…7,9 Of note, 5% of patients with NTS gastroenteritis ultimately develop bacteremia, of whom 40% go on to develop extraintestinal infection. 1 About 25% of patients over 50 found to have NTS bacteremia develop additional endovascular complications. 3 Diagnosis is primarily made radiographically with multiple modalities showing utility.…”

Section: Discussionmentioning

confidence: 99%

“…3 Following surgical intervention, patients require a prolonged course of antibiotics, typically in the range of 6-12 weeks, although some sources recommend lifelong suppressive therapy in select cases. 1,2,3,5 Clinical response and duration of treatment can be assessed through clearance of blood cultures and trending of inflammatory markers. 3,4…”

Section: Discussionmentioning

confidence: 99%

“…Mortality rates approach 100% without surgical intervention. [1][2][3] Symptoms are frequently vague and include abdominal and back pain, fevers, vomiting, and diarrhea. An initial workup in the emergency department (ED) using computed tomography (CT) with intravenous (IV) contrast may not be adequate to make the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Salmonella Aortitis in an Elderly Male, a Rare but Deadly Cause of Abdominal Pain: A Case Report

Yanushefski

Kaur

Eberhardt

2021

Clinical Practice and Cases in Emergency Medicine

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Introduction: Infectious aortitis is a rare condition with mortality rates approaching 100% without surgical intervention. Symptoms and findings may be vague. Computed tomography (CT) with intravenous (IV) contrast, once the gold standard of diagnosis, may only show subtle findings. More recently, CT angiography (CTA) and magnetic resonance angiography have become the diagnostic modalities of choice. Case Report: A 58-year-old diabetic male presented to our emergency department with nausea, vomiting, diarrhea, fevers, and abdominal pain of two weeks duration. The patient had been seen just days before at another facility with the same complaints. He received an abdominal CT with IV contrast that was reported as negative and discharged with the diagnosis of gastroenteritis. He failed to improve and presented to our facility. On presentation, the patient was diaphoretic and uncomfortable. A repeat abdominal CT with IV contrast revealed a mantle of low density around the aorta. The patient was started on IV antibiotics, and a follow-up CTA of the abdomen and pelvis showed an irregular saccular aneurysm. Vascular surgery was consulted, and the patient underwent vascular reconstruction. Conclusion: Because of the high level of mortality seen in infectious aortitis and improvement in patient outcomes with surgical intervention, a high index of suspicion needs to be maintained in patients presenting with fever and chest, abdominal, and back pain, especially in the setting of risk factors and bacteremia. The clinician should be aware that the usual modality for the evaluation of abdominal pain, CT with IV contrast, may not be adequate to make the diagnosis.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Salmonella Aortitis in an Elderly Male, a Rare but Deadly Cause of Abdominal Pain: A Case Report

Yanushefski

Kaur

Eberhardt

2021

Clinical Practice and Cases in Emergency Medicine

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Secondary vasculitides

Rose,

Iking-Konert

2024

Innere Medizin

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Spectrum of Large- and Medium-Vessel Vasculitis in Adults: Neoplastic, Infectious, Drug-Induced, Autoinflammatory, and Primary Immunodeficiency Diseases

et al. 2022

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Purpose of Review To provide a comprehensive review of drugs and neoplastic, infectious, autoinflammatory, and immunodeficiency diseases causing medium- to large-vessel vasculitis in adults with emphasis on information essential for the initial diagnostic process. Recent Findings Entities with medium- to large-vessel vasculitis as clinical manifestations have been described recently (e.g., adenosine deaminase-2 deficiency, VEXAS-Syndrome), and vasculitis in established autoinflammatory or immunodeficiency diseases is increasingly being identified. Summary In the diagnostic process of medium- to large-vessel vasculitis in adults, a large variety of rare diseases should be included in the differential diagnosis, especially if diagnosis is made without histologic confirmation and in younger patients. Although these disorders should be considered, they will undoubtedly remain rare in daily practice.

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Non-typhoidal Salmonella aortitis

Cited by 11 publications

References 13 publications

Salmonella Aortitis in an Elderly Male, a Rare but Deadly Cause of Abdominal Pain: A Case Report

Salmonella Aortitis in an Elderly Male, a Rare but Deadly Cause of Abdominal Pain: A Case Report

Secondary vasculitides

Spectrum of Large- and Medium-Vessel Vasculitis in Adults: Neoplastic, Infectious, Drug-Induced, Autoinflammatory, and Primary Immunodeficiency Diseases

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