title: Salmonella paratyphi B mycotic aneurysm of the abdominal aorta in an HIV-infected patient: a case report.
abstract: An HIV-infected 49-year-old man was admitted with polyuria, fever, chills and a dull left lumbar pain. Laboratory tests showed increased C-reactive protein while urine analysis and abdomen ultrasound scan were negative. Blood cultures revealed a Salmonella paratyphi B, identified through MALDI-TOF mass spectrometry. Targeted antibiotic therapy with intravenous piperacillin/tazobactam was started and a multi-phase contrast-enhanced abdomen CT-scan was performed at 24 hours from admission showing a saccular aneurysm of the abdominal aorta with a 1 cm penetrating aortic ulcer on posterior wall. The patient underwent emergency vascular surgery at 34 hours from admission for debridement and homo-graft placement of sub-renal aorta, and surgical samples were sent for microbiological analysis. Unfortunately, the patient died on post-surgical day 7 after haemorrhagic shock due to laceration of his graft. Salmonella paratyphi infection can be responsible for sepsis in severely immunosuppressed patients with poorly controlled HIV, requiring careful work-up for cardiovascular involvement.
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Girometti
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Giannella
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Brocchi
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Badia
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calza
authors.affiliation: Department of Medical Sciences and Surgery, Section of Infectious Diseases, University of Bologna; Operative Unit of Radiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000785:Aneurysm, Infected / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D012484:Salmonella paratyphi B / Q000302:isolation & purification; D012771:Shock, Hemorrhagic / Q000209:etiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects*