Image of the month: Mycotic aortic arch pseudoaneurysm due to Salmonella enterica

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Chronic Salmonella Infection Induced Intestinal Fibrosis
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Chronic Salmonella Infection Induced Intestinal Fibrosis

Published on: September 22, 2019

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Chunyan Jiang1, Hongwei Li2

  • 1Beijing Friendship Hospital, Beijing, China.

Clinical Medicine (London, England)
|November 25, 2022
PubMed

Insights

A patient developed a Salmonella-induced aortic arch pseudoaneurysm after dental surgery. Despite interventions, an aortoesophageal fistula led to fatal bleeding, highlighting rare infectious aortic complications.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • A 61-year-old male with hypertension and psoriasis, treated with adalimumab, presented with fever post-dental implantation.
  • Computed tomography revealed a pseudoaneurysm in the aortic arch.

Observation:

  • Blood cultures identified *Salmonella enterica*, leading to a diagnosis of a mycotic pseudoaneurysm.
  • The patient developed hoarseness and hemoptysis during treatment with cefoperazone-sulbactam.

Findings:

  • Initial treatment involved cefoperazone-sulbactam, followed by thoracic endovascular aortic repair and emergency open surgical repair.
  • Despite surgical interventions, the patient experienced acute upper gastrointestinal bleeding, confirmed as an aortoesophageal fistula.

Implications:

  • This case underscores the rare but severe complications of infectious pseudoaneurysms, particularly aortoesophageal fistulas.
  • Management of immunosuppressed patients with invasive procedures requires vigilance for unusual infectious sequelae.
  • The fatal outcome emphasizes the challenges in treating complex aortic infections and their fistulous complications.
Keywords:
Salmonella entericaaortic archmycotic aneurysmpseudoaneurysm

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