Infected abdominal aortic aneurysm caused by nontyphoid Salmonella in an immunocompromised patient with rheumatoid arthritis.
Nontyphoid Salmonella strains are important pathogens commonly found worldwide, typically causing gastrointestinal illness. Here, we report a case of a 66-yearold man with an abdominal aortic infected (or so-called mycotic) aneurysm caused by Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis). He had multiple risk factors for atherosclerosis: age over 60, a long history of smoking, an 8-year history of diabetes mellitus, and a 10-year history of rheumatoid arthritis treated with low-dose corticosteroids. Although he had presented with no episode of diarrhea or abdominal pain, the abdominal aortic infected aneurysm was diagnosed by blood cultures and was carefully followed up by computed tomography. An abdominal aneurysmectomy and autogenous in situ reconstruction were successfully performed consequently. Alertness to the possibility of endovascular infection is important, even if there are no symptoms except for persistent fever, when treating Salmonella bacteremia in an immunocompromised patient, particularly when there are associated atherosclerotic risk factors.
Department of Medicine and Rheumatology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Kayoko
K
Kaneko
Yoshinori
Y
Nonomura
Kaori
K
Watanabe
Ryuji
R
Koike
Tetsuo
T
Kubota
Masayoshi
M
Harigai
Yoshinori
Y
Inoue
Takehisa
T
Iwai
Nobuyuki
N
Miyasaka
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology*; D016470:Bacteremia / Q000150:complications / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012480:Salmonella Infections / Q000150:complications* / Q000276:immunology; D012477:Salmonella enteritidis; D015898:Tomography Scanners, X-Ray Computed
D000893:Anti-Inflammatory Agents; D011239:Prednisolone