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Salmonellal mycotic abdominal-aortic aneurysm
G P Lane1, A D Cochrane, D R Fone
1Royal Melbourne Hospital, Parkville, Vic.
Abstract:
A patient is described with a mycotic abdominal-aortic aneurysm that was caused by Salmonella typhimurium, who presented to hospital four months after a urinary-tract infection that was caused by the same organism. The urinary-tract infection may have resulted from an episode of transient salmonellal bacteraemia, the significance of which was not appreciated. The pathogenesis, clinical features, treatment and prognosis of arteritis due to Salmonella species are reviewed. The early diagnosis and appropriate treatment of salmonellal mycotic aortic aneurysm is vital for a satisfactory outcome.
Insights
A Salmonella typhimurium infection led to a mycotic abdominal-aortic aneurysm in a patient. Prompt diagnosis and treatment of this rare condition are crucial for a positive outcome.
Area of Science:
- Infectious Diseases
- Cardiovascular Medicine
- Vascular Surgery
Background:
- Mycotic aneurysms, particularly those involving the aorta, are rare but serious complications of bacterial infections.
- Salmonella species are an uncommon but recognized cause of infectious aortitis and mycotic aneurysms.
- Understanding the link between urinary tract infections and subsequent aortic aneurysms is critical for early intervention.
Observation:
- A case report details a patient who developed a mycotic abdominal-aortic aneurysm caused by Salmonella typhimurium.
- The aneurysm was diagnosed four months after a urinary tract infection caused by the same pathogen.
- Transient salmonellal bacteremia, potentially from the initial UTI, is hypothesized as the source of infection.
Findings:
- Salmonella typhimurium was identified as the causative agent of the mycotic abdominal-aortic aneurysm.
- The patient's history included a preceding urinary tract infection with the same organism.
- Review of literature on Salmonella-induced arteritis, focusing on pathogenesis, clinical presentation, and management.
Implications:
- Early diagnosis and prompt, appropriate treatment of salmonellal mycotic aortic aneurysms are vital for patient survival and favorable outcomes.
- Increased clinical suspicion for bacteremia in patients with urinary tract infections, even if seemingly resolved, is warranted.
- This case underscores the importance of recognizing and managing invasive Salmonella infections to prevent severe vascular complications.