Mycotic aneurysm presenting as acute pyelonephritis.
This report describes a 56-year-old man with a ruptured infected abdominal aortic aneurysm secondary to Salmonella bacteremia, initially presenting as acute pyelonephritis. Spike fever with severe back pain continued despite empiric antibiotic treatment at a local hospital. Hypotension with a sudden hemoglobin drop was observed on the second hospitalization day. Abdominal computed tomography to further examine the bleeding focus confirmed a rupture of the mycotic abdominal aortic aneurysm. This case was successfully treated through prompt surgical intervention and aggressive protracted antibiotic therapy. The case presented herein raises concerns about the uncommon but life-threatening mycotic aneurysm presented initially as acute pyelonephritis. Early diagnosis and appropriate surgical and antibiotic treatment of the Salmonella mycotic aortic aneurysm is crucial for a satisfactory outcome.
Chen
Jiann-Keh
JK
Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Lin
Ja-Liang
JL
Huang
Chiu-Ching
CC
Yu
Chun-Chen
CC
D000208:Acute Disease; D000785:Aneurysm, Infected / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D001019:Aortic Rupture / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000175:diagnosis*; D012480:Salmonella Infections / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D012477:Salmonella enteritidis / Q000302:isolation & purification*