A case report of endovascular stenting in Salmonella mycotic aneurysm: a successful procedure in an immunocompromised patient.
BACKGROUND
Mycotic aneurysms are associated with high mortality rates and are managed in the local setting with extra-anatomical bypass followed by ligation, exclusion and debridement of the aneurysm. This is the first case of successful endovascular stenting in an immunocompromised patient with Salmonella mycotic aneurysm.


METHODS
A middle-aged man who was HIV positive had Salmonella septicaemia. He developed abdominal pain 5 days after admission and a computed tomography (CT) scan of the abdomen revealed infrarenal aortitis. He developed a mycotic aneurysm 3 weeks later.


METHODS
He opted for endovascular stenting and after prolonged antibiotic therapy and negative blood cultures, he underwent the procedure using a Talent stent, with an iliac extension.


RESULTS
He was discharged 1 week after stenting and maintained on oral bactrim based on sensitivity. At 1-year follow-up, he remains well symptomatically and CT scan showed no endoleak or collection.


CONCLUSIONS
Endovascular stenting, though a fairly new procedure, can be successfully deployed even in a mycotic aneurysm in the right setting.
Kam
Ming Hian
MH
Section of Vascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Toh
Lim Kai
LK
Tan
Seck Guan
SG
Wong
Daniel
D
Chia
Kok Hoong
KH
D000785:Aneurysm, Infected / Q000188:drug therapy / Q000601:surgery* / Q000628:therapy; D015658:HIV Infections / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012480:Salmonella Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D012477:Salmonella enteritidis; D015607:Stents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D015662:Trimethoprim, Sulfamethoxazole Drug Combination