Salmonellal mycotic abdominal‐aortic aneurysm

Lane, Garry P.; Cochrane, Andrew; Fone, David R.

doi:10.5694/j.1326-5377.1988.tb120513.x

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…Infection has been suspected as a risk factor for AA for decades. Salmonella, Staphylococcus, and Streptococcu s species are common microorganisms . Septic emboli, bacteremic seeding into the arterial wall, and infections from adjacent surroundings of the aorta are potential causes .…”

Section: Discussionmentioning

confidence: 99%

“…Salmonella, Staphylococcus, and Streptococcus species are common microorganisms. [13][14][15][16][17][52][53][54][55][56] Septic emboli, bacteremic seeding into the arterial wall, and infections from adjacent surroundings of the aorta are potential causes. [57][58][59] During an infection episode, patients may have hemodynamic instability, impaired immunity, and systemic inflammation.…”

Section: Association Between Infections and Aa/admentioning

confidence: 99%

“…8 The known risk factors for AA/AD include congenital connective tissue disorders, older age, male sex, atherosclerotic cardiovascular disease, and tobacco smoking. [8][9][10][11] Cumulative case reports and case series [12][13][14][15][16][17] also suggested that endocarditis, septicemia, intra-abdominal infections, bone-related infections, genitourinary tract infections (GUTIs), and lower respiratory tract infections (LRTIs) may be associated with AA/AD.…”

mentioning

confidence: 99%

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Association of Infections and Use of Fluoroquinolones With the Risk of Aortic Aneurysm or Aortic Dissection

Dong¹,

Chang

Wang

et al. 2020

JAMA Intern Med

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IMPORTANCEPrior observational studies have suggested that fluoroquinolone use may be associated with more than 2-fold increased risk of aortic aneurysm or aortic dissection (AA/AD). These studies, however, did not fully consider the role of coexisting infections and the risk of fluoroquinolones relative to other antibiotics. OBJECTIVE To estimate the risk of AA/AD associated with infections and to assess the comparative risk of AA/AD associated with fluoroquinolones vs other antibiotics with similar indication profiles among patients with the same types of infections. DESIGNS, SETTINGS, AND PARTICIPANTSThis nested case-control study identified 21 651 176 adult patients from a nationwide population-based health insurance claims database from January 1, 2009, to November 30, 2015. Each incident case of AA/AD was matched with 10 control individuals by age, sex, and follow-up duration in the database using risk-set sampling. Analysis of the data was conducted from April 2019 to March 2020.EXPOSURES Infections and antibiotic use within a 60-day risk window before the occurrence of AA/AD. MAIN OUTCOMES AND MEASURESConditional logistic regression was used to estimate the odds ratios (ORs) and 95% CIs comparing infections for which fluoroquinolones are commonly used with no infection within a 60-day risk window before outcome occurrence, adjusting for baseline confounders and concomitant antibiotic use. The adjusted ORs comparing fluoroquinolones with antibiotics with similar indication profiles within patients with indicated infections were also estimated. RESULTSA total of 28 948 cases and 289 480 matched controls were included (71.37% male; mean [SD] age, 67.41 [15.03] years). Among these, the adjusted OR of AA/AD for any indicated infections was 1.73 (95% CI, 1.66-1.81). Septicemia (OR, 3.16; 95% CI, 2.63-3.78) and intra-abdominal infection (OR, 2.99; 95% CI, 2.45-3.65) had the highest increased risk. Fluoroquinolones were not associated with an increased AA/AD risk when compared with combined amoxicillin-clavulanate or combined ampicillin-sulbactam (OR, 1.01; 95% CI, 0.82-1.24) or with extended-spectrum cephalosporins (OR, 0.88; 95% CI, 0.70-1.11) among patients with indicated infections. The null findings for fluoroquinolone use remained robust in different subgroup and sensitivity analyses.CONCLUSIONS AND RELEVANCE These results highlight the importance of accounting for coexisting infections while examining the safety of antibiotics using real-world data; the findings suggest that concerns about AA/AD risk should not deter fluoroquinolone use for patients with indicated infections.

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Section: Discussionmentioning

confidence: 99%

Section: Association Between Infections and Aa/admentioning

confidence: 99%

mentioning

confidence: 99%

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Association of Infections and Use of Fluoroquinolones With the Risk of Aortic Aneurysm or Aortic Dissection

Dong¹,

Chang

Wang

et al. 2020

JAMA Intern Med

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“…Previous studies emphasized the importance of surgical resection of the endovascular infection. [1,4,7] Recent reports propose that aneurysm resection with 680 CHEN ET AL.…”

Section: Discussionmentioning

confidence: 99%

Mycotic Aneurysm Presenting as Acute Pyelonephritis

et al. 2002

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This report describes a 56-year-old man with a ruptured infected abdominal aortic aneurysm secondary to Salmonella bacteremia, initially presenting as acute pyelonephritis. Spike fever with severe back pain continued despite empiric antibiotic treatment at a local hospital. Hypotension with a sudden hemoglobin drop was observed on the second hospitalization day. Abdominal computed tomography to further examine the bleeding focus confirmed a rupture of the mycotic abdominal aortic aneurysm. This case was successfully treated through prompt surgical intervention and aggressive protracted antibiotic therapy. The case presented herein raises concerns about the uncommon but life-threatening mycotic aneurysm presented initially as acute pyelonephritis. Early diagnosis and appropriate surgical and antibiotic treatment of the Salmonella mycotic aortic aneurysm is crucial for a satisfactory outcome.

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“…Early diagnosis of salmonella arteritis, with ultrasound or CT scanning with contrast, is essential as 40% of patients die of vessel rupture or sepsis before surgery 4. Furthermore, arterial rupture can occur even before wall dilatation 8…”

Section: Discussionmentioning

confidence: 99%