Abstract
Nontyphoid Salmonella strains are important pathogens commonly found worldwide, typically causing gastrointestinal illness. Here, we report a case of a 66-yearold man with an abdominal aortic infected (or so-called mycotic) aneurysm caused by Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis). He had multiple risk factors for atherosclerosis: age over 60, a long history of smoking, an 8-year history of diabetes mellitus, and a 10-year history of rheumatoid arthritis treated with low-dose corticosteroids. Although he had presented with no episode of diarrhea or abdominal pain, the abdominal aortic infected aneurysm was diagnosed by blood cultures and was carefully followed up by computed tomography. An abdominal aneurysmectomy and autogenous in situ reconstruction were successfully performed consequently. Alertness to the possibility of endovascular infection is important, even if there are no symptoms except for persistent fever, when treating Salmonella bacteremia in an immunocompromised patient, particularly when there are associated atherosclerotic risk factors.
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Wang JH, Liu YC, Yen MY, Chen YS, Wann SR, Cheng DD. Mycotic aneurysm due to non-typhi salmonella: report of 16 cases. Clin Infect Dis 1996;23:743–747.
Fernández Guerrero ML, Aguado JM, Arribas A, Lumbreras C, de Gorgolas M. The spectrum of cardiovascular infections due to Salmonella enterica: a review of clinical features and factors determining outcome. Medicine (Baltimore) 2004;83:123–138.
Kearney RR, Eisen HJ, Wolf JE. Nonvalvular infections of the cardiovascular system. Ann Intern Med 1994;121:219–230.
Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandel LA, Manson JE, et al. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 2003; 107:1303–1307.
Solomon DH, Goodson NJ, Katz JN, Weinblatt ME, Avorn J, Setoguchi S, et al. Patterns of cardiovascular risk in rheumatoid arthritis. Ann Rheum Dis 2006;65:1608–1612.
del Rincón IP, Williams K, Stern MP, Freeman GL, Escalante A. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 2001;44:2737–2745.
Galofré J, Moreno A, Mensa J, Miro JM, Gatell JM, Almela M, et al. Analysis of factors influencing the outcome and development of septic metastasis or relapse in Salmonella bacteremia. Clin Infect Dis 1994;18:873–878.
Shimoni Z, Pitlik S, Leibovici L, Samra Z, Konigsberger H, Drucker M, et al. Nontyphoid Salmonella bacteremia: age-related differences in clinical presentation, bacteriology, and outcome. Clin Infect Dis 1999;28:822–827.
Yen YF, Lin YC, Chen TL, Chen YY, Lin ML, Wang FD, et al. Non-typhoidal Salmonella bacteremia in adults. J Microbiol Immunol Infect 2007;40:227–233.
Ramos JM, García-Corbeira P, Aguado JM, Arjona R, Alés JM, Soriano F. Clinical significance of primary vs secondary bacteremia due to nontyphoid Salmonella in patients without AIDS. Clin Infect Dis 1994;19:777–780.
Oderich GS, Panneton JM, Bower TC, Cherry KJ, Rowland CM, Noel AA, et al. Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg 2001;34:900–908.
Müller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg 2001;33:106–113.
Pegues DA, Ohl ME, Miller SI. Salmonella species, including Salmonella typhi. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 6th ed. New York: Elsevier/Churchill Livingstone; 2005. p. 2648.
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Kaneko, K., Nonomura, Y., Watanabe, K. et al. Infected abdominal aortic aneurysm caused by nontyphoid Salmonella in an immunocompromised patient with rheumatoid arthritis. J Infect Chemother 15, 312–315 (2009). https://doi.org/10.1007/s10156-009-0699-3
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DOI: https://doi.org/10.1007/s10156-009-0699-3