Fatal hemoptysis in dissecting aortic aneurysm and salmonellosis: a case report

Hemoptysis is a rare manifestation of dissecting aortic aneurysm and aortobronchial fistula may occur when an aortic aneurysm is mycotic, atherosclerotic, traumatic or postoperative. Aortobronchial fistulas are generally fatal if not treated surgically. An aggressive diagnostic approach to patients with hemoptysis and prompt surgical intervention in those suspected of aortobronchial fistulas should result in additional survivors. Imaging studies, including chest radiography, chest computerized tomography, arteriography and bronchoscopy provide useful diagnostic information. However, challenges remain when we encounter this condition. Sometimes, the final exsanguinating hemorrhage is preceded by a distinct prodromal period of intermittent hemoptysis. This allows clinicians time to recognize such fistulas and perform emergency surgery. We present a patient with this condition to alert clinicians to this potentially deadly cause of hemoptysis.