Salmonella aortitis. A report of a successfully treated case with a comprehensive review of the literature

Abstract

A successfully treated case of Salmonella infection of the thoracic aorta is described. Salmonella enteritidis was isolated from blood cultures and from operative cultures of the aorta. Computed tomography suggested the site of infection, and the resection of the thoracic aortic aneurysm with specific antibiotic therapy resulted in a satisfactory outcome. Although once invariably fatal, improved diagnostic roentgenographic techniques, more potent antibiotics, and surgical advances have resulted in at least 45 reported survivors over the last 15 years. The pathogenesis, clinical and laboratory characteristics, and the treatment of aortitis due to Salmonella species are reviewed in 98 cases reported in the English-language literature since 1948. Early diagnosis and a combination of prompt surgical intervention and antibiotic therapy are essential for survival.

Isolation of Salmonella enterica serotype choleraesuis resistant to ceftriaxone and ciprofloxacin

“…Nowadays, the use of the term "mycotic aneurysm" implies a wide spectrum of disease entities including all cases of true or pseudoaneurysms. Most of the patients with mycotic aneurysm due to Salmonella have preexisting atherosclerotic disease at the site of subsequently infected aneurysm (40,105). In a series of patients with bacteremia due to Salmonella, 25% of those older than 50 years developed an endothelial infection (40).…”

“…Mycotic aneurysm caused by Salmonella was almost uniformly fatal in previous times; however, multiple publications of case reports and case series found that early surgical intervention has greatly increased survival (3,27,63,105,131,142,150). Most surgeons consider the excision of an infected vessel with extra-anatomic vascular reconstruction to be the surgery of choice for abdominal mycotic aneurysm (142).…”

Salmonella Aortitis: A Case Report

“…2,7 Thus, it is not surprising to find that about 25% of patients with Salmonella aortitis have preexisting diabetes mellitus. 7,8 A third form of aortitis is known as microbial aortitis. This type of endovascular infection is associated with seeding of an atherosclerotic wall in the course of bacteremia with formation of a pseudoaneurysm, which lacks normal arterial layers.…”

“…7,8 A third form of aortitis is known as microbial aortitis. This type of endovascular infection is associated with seeding of an atherosclerotic wall in the course of bacteremia with formation of a pseudoaneurysm, which lacks normal arterial layers.…”

Mycotic Aneurysm of the Common Iliac Artery due to Salmonella Para Typhi A: A Case Report

“…Abdominal examination revealed guarding with severe tenderness in the left lower quadrant, an expanding tender mass 15 x 15 cm in diameter in the left iliac fossa, and weak pulses in the left lower limb. Laboratory investigations revealed a hemoglobin of 8.3 g/dL, white blood cell count 6000/mm 3 , platelet count 38,000/mm 3 , random blood sugar 20.5 mmol/L, serum creatinine 137 μmol/L, blood urea nitrogen 6.3 mmol/L, Na ++ 148 mmol/L, K + 3.3 mmol/L, CO 2 10 mmol/L, calcium 3.08 mmol/L. Chest x-ray was normal.…”