Simultaneous Salmonella spp. endocarditis and mycotic abdominal aortic aneurysm presentation: a surgical dilemma.
Concomitant valvular and abdominal aortic pathologies, both requiring urgent surgical interventions, are an uncommon entity. The ideal surgical management of such a scenario varies, depending on a host of variables. Due to its complexity and rarity, the ideal management approach remains an unknown. We describe a patient who presents with a delayed diagnosis of concomitant Salmonella species mitral valve (MV) endocarditis and mycotic abdominal aortic aneurysm (AAA). Though both clinical entities required urgent surgical intervention, the presence of one made intervening for the other high-risk and created a surgical dilemma. Following guarded conservative medical management, the patient underwent successful staged surgical interventions.
Department of Surgery, Section of Cardiac Surgery, Cardiac Sciences Program, St Boniface General Hospital, Winnipeg, Manitoba, Canada. kennykumar@shaw.ca
Kanwal
K
Kumar
Darren H
DH
Freed
Rakesh C
RC
Arora
John J Y
JJ
Lee
D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D003646:Debridement; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D012480:Salmonella Infections / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D012477:Salmonella enteritidis / Q000302:isolation & purification*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
D000900:Anti-Bacterial Agents