[Impending rupture of aneurysm of Salmonella-infected aortic arch]

We report a case of a 67-year-old man with Salmonella infected aortic arch aneurysm. The patient presented with persistent high fever, chest pain, back pain and hoarseness. Laboratory studies showed the presence of severe inflammation. Both impending rupture and saccular aneurysm were suspected by preoperative computed tomography (CT), magnetic resonance imaging (MRI) and angiography and diagnosis was, therefore difficult to make. We conducted semi-emergency total aortic arch replacement, under deep hypothermic circulatory arrest and retrograde cerebral perfusion. Salmonella was identified in the aneurysmal wall and antibiotics were administered for 6 weeks until CRP was normalized, when they were replaced by oral antibiotics. Postoperative course was uneventful. The patient was discharged on the 60th postoperative day. He continues to take oral antibiotics.