1/21. 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 = aortitis (Clic here for more details about this article) |
2/21. 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 = 0.5keywords = aortitis (Clic here for more details about this article) |
3/21. Fatal salmonella aortitis with mycotic aneurysm rupture.Salmonellae most commonly cause uncomplicated cases of gastroenteritis but have a predilection for damaged blood vessels, especially those damaged by atherosclerosis. The abdominal aorta is most frequently affected. The most serious complication of aortitis is mycotic aneurysm formation with subsequent rupture. The authors present the case of a 61-year-old man who was found unresponsive at home 3 days after discharge from the hospital for treatment of gastroenteritis with bacteremia. Postmortem examination revealed a ruptured mycotic aneurysm with a large retroperitoneal hematoma. Numerous gram-negative rods were embedded in the wall of the aorta and surrounding inflammatory infiltrate, compatible with the patient's previously isolated. Whereas abdominal aortic aneurysm rupture is most commonly associated with atherosclerosis, the isolation of from blood cultures, coupled with radiographic evidence of gas surrounding the aorta, should raise the suspicion of infectious aortitis. Whereas fatal rupture of an aortic aneurysm secondary to atherosclerosis alone or in conjunction with aortitis will not have an impact on the manner of death, infections are reportable and thus have public health implications.- - - - - - - - - - ranking = 3.5keywords = aortitis (Clic here for more details about this article) |
4/21. Mycotic aneurysm of the abdominal aorta with retroperitoneal abscess: successful endovascular repair.Mycotic aortic aneurysms are rare. Improved diagnostic procedures, appropriate antibiotic treatment, and safe surgical techniques have reduced the high mortality associated with bacterial aortitis. However, definite evidence-based conclusions with regard to the surgical strategy cannot be drawn from the data available in the published literature. We report successful endovascular repair of a mycotic abdominal aortic aneurysm. Endovascular treatment may offer a benefit, especially in critically ill patients.- - - - - - - - - - ranking = 0.5keywords = aortitis (Clic here for more details about this article) |
5/21. Salmonella aortic aneurysm: suggestions for diagnosis and therapy based on personal experience--a case report.Infectious aneurysm is a rare event, especially after the introduction of antibiotic therapy. However, its early detection is very important for timely treatment with antibiotics and surgical intervention. This pathology may generally be due to mycotic endocarditis or septic embolization, prevailing in the preantibiotic era, and to aortitis, whose incidence is actually increasing, mainly in subjects with preexisting large-vessel atherosclerosis and intimal defects. This clinical entity is usually defined as microbial arteritis and recognizes Salmonella spp as the microorganism most frequently isolated from blood or vascular tissue cultures. The authors present the case of a 56-year-old man with a history of hypertension that some weeks before admission manifested as hyperpyrexia and episodic lumbar pain, associated with hepatosplenomegaly and with a pulsing mass in the periumbilical region. Abdominal computed tomography (CT) scan documented a voluminous infrarenal aortic aneurysm with a markedly reduced and irregular vessel wall. The patient underwent surgical excision of the aneurysm, during which marked periaortic inflammation phenomena, complete absence of the posterior aortic wall for a length of 5-6 cm, and the exposure of the correspondent vertebral bodies were observed. Histopathologic examination of the aneurysmal tissue showed atheromatous and thrombotic aspects and confirmed strong signs of inflammation. This case may suggest that the occurrence of microbial aortitis, especially from Salmonella spp, should be taken into account in the presence of a septic status associated with back, abdominal, or thoracic pain.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
6/21. Successful coaxial double-vein graft for infrarenal aortic pseudoaneurysm due to Salmonella infection associated with hepatic resection for hepatocarcinoma.This is a case of aortic pseudoaneurysm due to Salmonella aortitis successfully treated by coaxial double-vein graft replacement (femoral vein and internal jugular vein) associated with hepatic resection for hepatocarcinoma. The aim of the technique is to improve the solidness of the vascular anastomosis and the tensile strength of the autologous vein graft, thus preventing long-term degeneration. Simultaneous hepatic resection did not affect clinical outcome. At 5-year follow-up, neither morphological alteration of the double-vein graft nor neoplastic relapse of the hepatocellular carcinoma was observed. This surgical technique could potentially improve long-term outcome and could therefore be considered a useful modification of the classic femoral vein graft for substitution of the septic infrarenal aorta when an extension to the iliac or femoral artery is not necessary.- - - - - - - - - - ranking = 0.5keywords = aortitis (Clic here for more details about this article) |
7/21. Salmonella reinfection manifesting as a fistula between the duodenum and an aortic stump pseudoaneurysm.Despite the worldwide increase in salmonella infections, a Salmonella infection of an aortic graft is an exceptional event. A Salmonella reinfection manifesting as a fistula between the duodenum and an aortic stump pseudoaneurysm 30 months after prosthetic excision, aortic ligature and extra-anatomic bypass for a Salmonella graft infection is a unique event. This unusual late complication described in this case report developed in 1 of the 5 patients whose Salmonella aortic graft infections have been previously reported. The reinfection causing septic aortitis responded to conventional surgery.- - - - - - - - - - ranking = 0.5keywords = aortitis (Clic here for more details about this article) |
8/21. An unusual presentation of salmonellal aortitis.Our patient represents what we believe to be the first documented case of Salmonella choleraesuis aortitis presenting as a salmonellal empyema in an elderly diabetic man. Although S choleraesuis often causes septicemia, its absence should not lead one to forget the pathogenic nature of and high mortality associated with this organism. Aggressive efforts must be made to search for endovascular infection, because cures can be achieved only with surgical intervention and prolonged antibiotic therapy.- - - - - - - - - - ranking = 2.5keywords = aortitis (Clic here for more details about this article) |
9/21. Salmonella aortitis and aneurysm formation: the role of CT in management.A case of salmonella aortitis and aneurysm formation with subsequent necrosis of the arterial wall is described. Computed tomography is beneficial in diagnosis and management and should be carried out early in the course of illness.- - - - - - - - - - ranking = 2.5keywords = aortitis (Clic here for more details about this article) |
10/21. Impending rupture of nonaneurysmal bacterial aortitis: CT diagnosis.The CT appearance of mycotic abdominal aortic aneurysms leading to eventual rupture has been well described. On the other hand, ruptured nonaneurysmal bacterial aortitis has not been demonstrated in the CT literature. We present two cases with subsequent rupture documented on CT. The characteristic findings of periaortic density and adjacent gas collection should suggest the diagnosis of acute aortic infection. This may herald impending rupture, even in the absence of aneurysmal dilatation, and should direct therapy accordingly.- - - - - - - - - - ranking = 2.5keywords = aortitis (Clic here for more details about this article) |
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