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Case Reports
. 2018 Dec 21:15:e00476.
doi: 10.1016/j.idcr.2018.e00476. eCollection 2019.

Salmonella Typhimurium para-aortic root abscess managed non-surgically

Tarek Haykal  1   2 , Abdul Rahman Al Bizri  3 , Thair Dawood  1   2 , Danielle Osterholzer  1   2   4
Affiliations
Case Reports

Salmonella Typhimurium para-aortic root abscess managed non-surgically

Tarek Haykal et al. IDCases. .

Abstract

Introduction: Para-aortic root abscess is a destructive vascular condition that can result in significant morbidity and mortality. We describe a rare case of para-aortic root abscess due to Salmonella Typhimurium that was successfully managed medically.

Presentation of case: A 72-year-old diabetic man with a prosthetic aortic graft presented with fever and expressive aphasia with left sided weakness. Magnetic resonance imaging (MRI) of the brain showed multiple embolic cerebral vascular accidents. Computed tomography angiography (CTA) of the chest showed a 5.7 × 2.7 cm (cm) para-aortic root abscess. Blood cultures grew Salmonella Typhimurium. The patient was started on ceftriaxone initially, and then ciprofloxacin was added on day 5. Given an unacceptably high risk of mortality expected with surgery, the patient was managed medically.After five months of both ceftriaxone and ciprofloxacin, ceftriaxone was stopped. Twelve months later, the patient is doing well on ciprofloxacin alone with a plan for lifelong suppression.

Discussion: Cases of para-aortic root abscess due to Salmonella Typhimurium have not been reported in the literature. There are no guidelines to dictate the antibiotic choice or management of para-aortic root abscess due to Salmonella Typhimurium.

Conclusion: This report adds to the body of literature regarding the treatment of this infection including successful non-surgical management.

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Figures

Fig. 1
Fig. 1
Contrast-enhanced CT axial view of the chest showing para-aortic root collection containing pockets of gas in keeping with para-aortic root abscess.
Fig. 2
Fig. 2
Contrast-enhanced CT coronal view of the chest showing para-aortic root collection containing pockets of gas in keeping with para-aortic root abscess.
Fig. 3
Fig. 3
PET-scan axial view showing para-aortic collection, predominantly photopenic with intense FDG-uptake identified at the inferior most component (medial aspect of the aortic root). Findings are keeping with patient's infectious para-aortic abscess.
Fig. 4
Fig. 4
PET-scan coronal view showing para-aortic collection, predominantly photopenic with intense FDG-uptake identified at the inferior most component (medial aspect of the aortic root). Findings are keeping with patient's infectious para-aortic abscess.
See this image and copyright information in PMC

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