[Salmonella typhimurium aortitis]

Abstract

Salmonella tiphymurium infection frequently causes gastroenteritis but some cases have a predilection for damaged blood vessels, especially those affected by atherosclerosis. The abdominal aorta is the most frequent location. Salmonella aortitis with mycotic aneurysm formation is a rare but serious condition, due to the high risk of rupture. We report the clinical case of a 61 year old man with a history of diabetes and hypertension, who was previously admitted with Salmonella gastroenteritis for which he had been treated with proper antibiotics. He was readmitted with fever, nausea and low back pain. Salmonella thyphimurium was isolated in blood cultures. The investigation revealed a pseudoaneurysm formation on the abdominal aorta. He was submitted to surgical vascular grafting with aneurysm resection and antibiotic therapy before and after surgery, with excellent clinical outcome. Bacteremia due to Salmonella Typhymurium must always raise the suspicion of focalization, especially a vascular infection. Particular attention should be given to predisposing factors, such as pre-existent atherosclerosis and age. The advised treatment of mycotic aneurysm due to a Salmonella agent must be a combined medical and surgical therapy.