1/116. Salmonella mycotic aneurysms: traditional and "alternative" surgical repair with arterial homograft.Salmonella infection of the abdominal aorta with formation of mycotic aneurysm is rare, but associated with a high mortality and morbidity. Prompt surgical treatment and selective and prolonged antibiotic therapy are required because of its rapid and impredictable evolution in a short period of time, even if an infectivous etiology is only suspected. methods of revascularization can be different: the traditional two are in situ or extraanatomic bypass using synthetic graft. Both these solutions are subject to complications. An "alternative" method of revascularization with low risk of infection and good patency is the use of arterial homograft in situ. We report two cases of Salmonella mycotic aortic aneurysms successfully treated with revascularization respectively by extraanatomic bypass using synthetic graft and in situ arterial homograft. The reasons for our choice are also discussed.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/116. Muscle infections caused by Salmonella species: case report and review.We describe a patient with salmonella pyomyositis and review 30 other cases reported during the past 4 decades. Men outnumbered women by 2.9 to 1, and the median age of the patients was 51 years. Approximately one-half the cases were caused by salmonella enteritidis. Infected vascular aneurysms were observed in seven patients. Prior salmonella infections and local trauma or lesions were common. Diverse underlying conditions, mainly diabetes and human immunodeficiency virus infection, were present in 81% of the patients, and the psoas muscle was involved in 55% of the cases. One-third of the patients died, and relapses were common after a median time of 5 weeks (range, 4.5-27 weeks) in those who survived. Most patients had anemia, and pathogens were recovered from blood samples from two-thirds of the patients. Salmonella should be considered as a causative agent of muscle infections in the appropriate clinical setting, particularly in patients with underlying diseases or preexisting vascular aneurysms.- - - - - - - - - - ranking = 0.33333333333333keywords = aneurysm (Clic here for more details about this article) |
3/116. Fatal hemoptysis in dissecting aortic aneurysm and salmonellosis: a case report.hemoptysis is a rare manifestation of dissecting aortic aneurysm and aortobronchial fistula may occur when an aortic aneurysm is mycotic, atherosclerotic, traumatic or postoperative. Aortobronchial fistulas are generally fatal if not treated surgically. An aggressive diagnostic approach to patients with hemoptysis and prompt surgical intervention in those suspected of aortobronchial fistulas should result in additional survivors. Imaging studies, including chest radiography, chest computerized tomography, arteriography and bronchoscopy provide useful diagnostic information. However, challenges remain when we encounter this condition. Sometimes, the final exsanguinating hemorrhage is preceded by a distinct prodromal period of intermittent hemoptysis. This allows clinicians time to recognize such fistulas and perform emergency surgery. We present a patient with this condition to alert clinicians to this potentially deadly cause of hemoptysis.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
4/116. A patient with fever and an abdominal aortic aneurysm.A 55-year-old man with an abdominal aortic aneurysm presented with fever and abdominal pain 3 weeks after an episode of Salmonella gastroenteritis. His symptoms persisted despite antimicrobial therapy. Two abdominal computed tomography (CT) scans showed no evidence of aortitis. His abdominal pain worsened and further investigation including a third CT scan demonstrated a leaking aortic aneurysm. The wall of the aorta was shown to contain Gram-negative bacilli. This case illustrates the difficulty in diagnosing bacterial aortitis.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
5/116. Salmonella infection of a ventricular aneurysm with mural thrombus.We describe a case of salmonella infection of a left ventricular aneurysm with a mural thrombus and review 12 cases described in the literature. This entity should be looked for in any patient with persistent or relapsing salmonella bacteremia in whom an intracardiac thrombus is demonstrated. Nuclear imaging may help in the diagnosis. A combined medical and surgical approach should be aggressively pursued because patients who do not undergo an aneurysmectomy are unlikely to survive.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
6/116. Primary repair with in-situ interposition graft for infrarenal mycotic aortic pseudoaneurysm.This is a case report of a pseudoaneurysm due to Salmonella aortitis in a 52 year old man. The condition is rare and represents one of the few cases reported in malaysia. The diagnosis was made preoperatively by ultrasonography and computed tomography. This was confirmed at surgery where there was a 3 cm defect at the posterior wall of the aorta at L2/3 level. The aneurysmal sac extended to the retrocrural space at the 12th vertebra level cranially on the right side to the lower border of the 3rd lumbar vertebra caudally. It had a smooth fibrous wall and contained a mixture of organised haematoma and pus. At operation the aneurysm was excised, the affected region was carefully debrided and the aorta grafted with an in-situ in-lay graft. Antibiotic therapy was instituted until clinical response was evident, leukocytosis was reduced and blood culture was negative. However 4 months after surgery, the patient returned in irreversible shock and succumbed to disseminated intravascular coagulation secondary to massive upper gastrointestinal haemorrhage from an aortoduodenal fistula.- - - - - - - - - - ranking = 1.272616708471keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
7/116. Ventriculotomy and resection for left ventricular thrombus infection with Salmonella.We report the case of a patient with a left ventricular thrombus infected by Salmonella. The diagnosis was suspected from a gallium scan demonstrating an intense activity in the lower left parasternal area. A transesophageal echocardiogram confirmed a calcified left ventricular aneurysm with a mural thrombus containing pus and heterogeneous material. The patient underwent a successful left ventricular aneurysmectomy, thrombectomy and endocardial resection under cardiopulmonary bypass which brought the infection under control.- - - - - - - - - - ranking = 0.33333333333333keywords = aneurysm (Clic here for more details about this article) |
8/116. Mycotic aneurysm of the carotid bifurcation in the neck: case report and review of the literature.OBJECTIVE AND IMPORTANCE: Mycotic aneurysms of the extracranial carotid artery are rare and difficult to diagnose. A search of the world literature published since 1966 reveals at least six cases of mycotic carotid aneurysms due to a Salmonella septicemia. We present an exceptional case of mycotic pseudoaneurysm of the bifurcation of the carotid artery due to Salmonella septicemia and discuss the pathogenesis as well as various aspects of the diagnosis and surgical management. CLINICAL PRESENTATION: A 68-year-old man presented in poland with Salmonella sepsis; 1 month later, he was admitted to the emergency department of the Sir Mortimer B. Davis-Jewish General Hospital in Montreal with a bulky and pulsatile right cervical mass. An angiogram and a computed tomographic scan revealed a voluminous and partially thrombosed aneurysm the size of a tangerine originating from the posterior aspect of the carotid junction. INTERVENTION: Balloon trapping was attempted at the Montreal Neurological Hospital. Subsequently, the patient developed a significant neurological deficit, which was quickly reversed by the administration of hypertensive, hypervolemic, and hemodilution therapy. Thereafter, the pseudoaneurysm was resected surgically, and the internal and external carotid arteries were sacrificed. Pathological examination of the excised specimen of the carotid junction revealed a pseudoaneurysm. Bacterial culture of the lesion showed growth of Salmonella. CONCLUSION: The postoperative course was satisfactory except for laryngeal paralysis due to involvement of the vagus nerve. Four months later, a computed tomographic scan showed only small lacunae in both centra semiovale.- - - - - - - - - - ranking = 1.7302366917493keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
9/116. Extraintestinal infection by group C Salmonella: a case report and review of the literature.Infected or mycotic aneurysms of the aorta are not very frequent but they are associated with high morbidity and mortality rates. Vascular infections due to Salmonella are not very frequent, but in recent years the reports of infections of this type have been on the increase. The authors report their experience with a case of aneurysm of the abdominal aorta infected by group C Salmonella and go on to review the literature on the subject.- - - - - - - - - - ranking = 0.33333333333333keywords = aneurysm (Clic here for more details about this article) |
10/116. Mycotic (infected) aneurysm of the popliteal artery and arthritis following Salmonella bacteriemia.We report a case of a mycotic (infected) aneurysm of the popliteal artery due to salmonella enteritidis. The clinical presentation may be confused with other more common causes of diffuse swollen leg, causing a delay in the diagnosis and proper therapy. Prompt surgical resection of the infected aneurysm together with medical therapy is required for successful treatment.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
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