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Mycotic aneurysm presenting as acute pyelonephritis.
Jiann-Keh Chen1, Ja-Liang Lin, Chiu-Ching Huang
1Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Renal Failure
|October 17, 2002
Summary
Salmonella bacteremia can cause a rare but deadly mycotic abdominal aortic aneurysm, initially mimicking pyelonephritis. Prompt surgery and antibiotics are vital for treating this serious infection.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Medical Case Reports
Background:
- Mycotic abdominal aortic aneurysms (MAA) are rare but life-threatening vascular infections.
- Salmonella bacteremia is an uncommon cause of MAA.
- MAA can present with non-specific symptoms, delaying diagnosis.
Observation:
- A 56-year-old man presented with symptoms suggestive of acute pyelonephritis, including fever and back pain.
- Despite initial antibiotic treatment, the patient developed hypotension and a significant drop in hemoglobin.
- Abdominal computed tomography revealed a ruptured mycotic abdominal aortic aneurysm secondary to Salmonella bacteremia.
Findings:
- The patient underwent successful surgical intervention and received prolonged antibiotic therapy.
- Early diagnosis and prompt, aggressive treatment are critical for managing Salmonella-induced MAA.
- This case highlights the importance of considering MAA in patients with unexplained symptoms and bacteremia.
Implications:
- Clinicians should maintain a high index of suspicion for MAA in patients with Salmonella bacteremia and atypical presentations.
- Timely diagnosis through advanced imaging is crucial for surgical planning and patient outcomes.
- Effective management requires a multidisciplinary approach involving infectious disease specialists and vascular surgeons.