Cardiac aneurysm complicated by Salmonella abscess. A clinicopathologic correlation in two patients

Two patients have been documented in whom a preexisting left ventricular aneurysm became complicated by myocardial abscess. Presumptive clinical diagnoses of infected pulmonary infarction and recurrent myocardial infarction were made. In each instance the abscess was revealed at necropsy. Histologic studies suggested that the abscess had occurred through direct spread from an infectious mural endocarditis. This mechanism could be related to the nature of the inner coating, which in both instances revealed evidence of organizing thrombosis with incorporation into the wall of the aneurysms. The observations reemphasize the need to consider the possibility of an infectious cardiac complication in every patient who presents with puzzling and nondiagnostic symptoms but in whom signs of an infectious process are present.