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Infectious Aortitis: A Life-Threatening Endovascular Complication of Nontyphoidal
Salmonella Bacteremia
#MMPMID29808097
Hakim S
; Davila F
; Amin M
; Hader I
; Cappell MS
Case Rep Med
2018[]; 2018
(?): 6845617
PMID29808097
show ga
A 65-year-old Japanese man living in the United States presented with pyrexia and
chills associated with intermittent lower abdominal and back pain for 5 days. He
denied recent travel, rash, diarrhea, or rectal bleeding. Physical examination
revealed spiking pyrexia, and routine laboratory tests revealed mild leukocytosis
and neutrophilia. Abdominal CT with contrast showed findings highly compatible
with aortitis. Comprehensive autoimmune evaluation was negative. Salmonella
enterica serotype Enteritidis was isolated from blood cultures. IV antibiotics
were administered, but the patient continued to experience low-grade pyrexia and
mild leukocytosis, and follow-up abdominal CT showed progressive aortic
inflammation. The patient therefore underwent resection of the affected aortic
segment with in-situ graft replacement and lifelong suppressive antibiotics. The
patient is asymptomatic with no complications at 18 weeks of follow-up. This case
report illustrates that patients with infectious aortitis from nontyphoidal
Salmonella may (1) present with nonspecific and nonlocalizing symptoms and signs
except for sepsis; (2) have diagnostic blood cultures and abdominal CT findings;
and (3) typically require aggressive, prolonged IV antibiotic therapy and surgery
for potential cure of this life-threatening infection.
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