Related Experiment Videos
Salmonella infections of the abdominal aorta cured with prolonged antibiotic treatment
Abstract:
Three cases of endovascular infection of atherosclerotic aneurysm of the abdominal aorta due to Salmonella spp. are described. 'Breakthrough' or relapsing bacteraemia were major clues for diagnosis in each case. They were treated with a prolonged course of bactericidal antibiotics before surgery. Resection with an interposed graft was performed in all cases and antibiotic treatment continued. Two of our patients have survived for more than two years and the other for 18 months without evidence of relapse. Thus, it would appear possible at times to treat successfully mycotic aneurysm of the abdominal aorta with antimicrobial agents plus resection of the aneurysm followed by in situ bypass grafting. Extra-anatomical grafts should be kept for infections due to antimicrobial-resistant organisms or when periaortic infection is widespread.
Insights
Salmonella spp. infections of abdominal aortic aneurysms can be successfully treated with antibiotics and surgical resection. This approach, combining antimicrobial therapy with in situ bypass grafting, offers a viable option for managing these complex cases.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Cardiovascular Research
Background:
- Endovascular infections of atherosclerotic abdominal aortic aneurysms (AAAs) are rare but serious conditions.
- Salmonella spp. are a common cause of mycotic aneurysms.
Observation:
- Three cases of Salmonella spp. infected atherosclerotic AAAs are presented.
- 'Breakthrough' or relapsing bacteremia served as key diagnostic indicators.
- Patients received prolonged bactericidal antibiotic therapy prior to surgical intervention.
Findings:
- All patients underwent aneurysm resection with in situ bypass grafting.
- Post-operative antibiotic treatment was continued.
- Two patients survived over two years, and one survived 18 months with no relapse.
Implications:
- A combined approach of antimicrobial agents and surgical resection with in situ bypass grafting can successfully treat mycotic abdominal aortic aneurysms.
- Extra-anatomical grafts are reserved for cases with antimicrobial-resistant organisms or widespread infection.