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Published on: July 22, 2011
An Unusual Case of Mycotic Popliteal Aneurysm Presenting as Recurrent Salmonella enteritidis Bacteraemia
Shuwei Zheng1, Cheng Chuan Lee2
1Department of Infectious Diseases, Singapore General Hospital, Singapore.
Abstract:
We describe a patient with a Salmonella enteritidis mycotic aneurysm. A 91-year-old man presented with recurrent episodes of S. enteritidis bacteraemia 2 months apart. During the second presentation, he underwent magnetic resonance imaging of the left lower limb that revealed rupture of the popliteal artery with a popliteal fossa collection. This was aspirated and cultures grew S. enteritidis. He underwent endovascular stenting and received a prolonged course of antibiotics. Popliteal artery mycotic aneurysm should be considered as a differential in patients presenting with unilateral painful leg swelling and bacteraemia from microorganisms with a propensity for endovascular infections.
Learning Points:
Our case illustrates a rare and unusual entity of ruptured popliteal mycotic aneurysm in an otherwise common scenario of recurrent nontyphoidal salmonellosis.In patients with recurrent Salmonella bacteraemia, clinicians often perform computed tomography scans to look for extraintestinal sites of involvement; however, this frequently misses any peripherally sited aneurysms, which often do not manifest with any early clinical symptoms.
Insights
A rare Salmonella enteritidis mycotic aneurysm ruptured in a 91-year-old man. This case highlights the need to consider mycotic aneurysms in patients with recurrent Salmonella bacteraemia and leg swelling.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Medical Case Reports
Background:
- Recurrent Salmonella bacteraemia can indicate underlying complications.
- Mycotic aneurysms are rare but serious vascular infections.
- Popliteal artery aneurysms may present with leg swelling and pain.
Purpose of the Study:
- To report a case of Salmonella enteritidis mycotic aneurysm.
- To highlight diagnostic challenges in peripheral mycotic aneurysms.
- To emphasize the importance of considering mycotic aneurysms in specific clinical scenarios.
Main Methods:
- Case presentation of a 91-year-old male patient.
- Magnetic resonance imaging (MRI) for diagnosis.
- Aspiration and culture of popliteal fossa collection.
- Endovascular stenting and antibiotic treatment.
Main Results:
- Salmonella enteritidis was identified as the causative agent.
- Ruptured popliteal artery mycotic aneurysm was diagnosed.
- Successful endovascular stenting and antibiotic therapy were administered.
Conclusions:
- Ruptured popliteal mycotic aneurysm is a rare complication of recurrent Salmonella bacteraemia.
- Standard imaging like CT scans may miss peripherally sited aneurysms.
- Consider mycotic aneurysms in patients with unilateral leg swelling and recurrent bacteraemia.
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