Salmonella-related mycotic pseudoaneurysm of the superficial femoral artery

Surgical treatment of a Salmonella-related infective native aortic aneurysm: A case report

Infective native abdominal aortic aneurysms are a life-threatening condition with a high mortality rate. We report the case of a 53-year-old male patient who presented with abdominal pain and fever. Laboratory results showed an elevated white blood cell count and C-reactive protein levels. Blood cultures detected Salmonella species, and computed tomography revealed a saccular abdominal aortic aneurysm. After 14 days of preoperative antibiotic therapy, the patient underwent a successful surgical bypass from the descending thoracic aorta, through the diaphragm and muscle layers of the anterior abdominal wall, to the bilateral common femoral arteries. The patient was discharged after 30 days of hospitalization and continued antibiotic treatment for another 30 days. Follow-up clinical evaluations and imaging studies showed good recovery and no signs of infection. This case highlights the importance of combining appropriate antibiotic therapy with surgical intervention in managing infective native aortic aneurysms. In particular, an extra-anatomical approach from the descending aorta can be a viable option in selected cases of infected aortic aneurysms, providing an effective means to achieve thorough debridement and prevent future graft infections.

Mycotic Pseudoaneurysm of Thoracic Aortic Caused by Salmonella Paratyphi A: A Case Report

Background

Mycotic pseudoaneurysm, also known as infectious pseudoaneurysm, is a severe disease with a high mortality rate. Although Salmonella infection is a common etiological factor for mycotic pseudoaneurysm, Salmonella paratyphi A infection causing mycotic pseudoaneurysm is extremely rare. Endovascular therapy has been described as a feasible treatment for mycotic pseudoaneurysm.

Case Presentation

A 63-year-old female patient had a thoracic aortic pseudoaneurysm caused by Salmonella paratyphi A infection. The patient associated with diabetes had a fever, abdominal pain, and low back pain, who was successfully treated using endovascular stents treatment and antibiotics.

Conclusion

Salmonella paratyphi A is a bloodstream infection bacterium with the ability to cause mycotic pseudoaneurysm. To treat mycotic pseudoaneurysms of the thoracic aorta, endovascular stent-graft treatment combined with antibiotics is an alternative treatment for patients who cannot tolerate open surgery.

Spontaneous Superficial Femoral Artery Mycotic Aneurysm

Peripheral artery mycotic aneurysms are rare occurrences. In this case, we review a 52-year-old lady with poorly controlled diabetes who developed a spontaneous left superficial artery mycotic aneurysm. She underwent excision and subsequent extra-anatomic bypass with a great saphenous vein graft. She had full functional recovery after a short period of rehabilitation.

Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

The mortality of patients with mycotic aneurysms is high, especially in East Asia, and infection by Salmonella species is the most common. Our study aimed to improve prognosis of adult mycotic aneurysms with early diagnosis and accurate treatment. Four adult patients with mycotic aneurysm caused by Salmonella were included and analyzed by single-center retrospective analysis. Cases reported in the literature during the past 10 years were also summarized. The average age of the 4 male patients was 61.25 years, while that of the 53 cases reported in the literature was 65.13 years. Hypertension, diabetes, and atherosclerosis were common complications. Most patients presented fever and experienced pain at the corresponding position of the aneurysm. Laboratory examination found an increased number of white blood cells accompanied by an increase in inflammatory markers. Most aneurysms were found in the abdominal aorta, while the rupture of an aneurysm was the most common complication. The mortality rates were 21.43 and 7.14% after open surgery or endovascular aneurysm repair (EVAR) intervention, respectively. The recurrence rates of infection were 0 and 17.85% for both treatments, respectively. The mortality rate of mycotic aneurysm caused by Salmonella infection was high in middle-aged males with hypertension, diabetes, and atherosclerosis. The possibility of a Salmonella-infected aneurysm should be considered in these high-risk groups presenting chills, fever, chest, and back pain. Open surgery was superior to EVAR treatment in the clearance of infected foci and the reduction of postoperative recurrence. The recurrence of postoperative infection can be prevented by intravenous antibiotic therapy for 6 weeks post-surgery.

Infrarenal Infected Aortic Aneurysm Caused by Streptococcus pyogenes

Infectious aneurysm is a rare entity associated with significant morbidity and mortality. Current knowledge on pathogenesis, outcome, diagnosis, management, and follow-up remains debatable. We report the case of a patient with Streptococcus pyogenes aneurysm who was successfully treated with a homograft implant and discuss microbiological characteristics, diagnostic methods, and treatment options currently available for this serious disease.

Diagnosis and management of a ruptured popliteal mycotic pseudoaneurysm

Infected popliteal aneurysms are a rare but high-risk pathology that may present as a surgical emergency with acute rupture and sepsis. Management of acute ischemia in the presence of systemic sepsis is challenging and requires timely diagnosis, rapid intervention, and multidisciplinary communication to ensure an optimum outcome for both life and limb in these patients. We report on a case of a ruptured mycotic popliteal artery aneurysm as a consequence of septic embolization from infective endocarditis managed by reverse saphenous vein bypass. The clinical presentation, diagnostic process, and approach to management along with a literature review on mycotic popliteal aneurysm are presented in this case report.