A case report of endovascular stenting in Salmonella mycotic aneurysm: a successful procedure in an immunocompromised patient.
- Author:
Ming Hian KAM
1
;
Lim Kai TOH
;
Seck Guan TAN
;
Daniel WONG
;
Kok Hoong CHIA
Author Information
- Publication Type:Case Reports
- MeSH: Aneurysm, Infected; drug therapy; surgery; therapy; HIV Infections; physiopathology; Humans; Male; Middle Aged; Salmonella Infections; drug therapy; microbiology; surgery; Salmonella enteritidis; Stents; Trimethoprim, Sulfamethoxazole Drug Combination; therapeutic use
- From:Annals of the Academy of Medicine, Singapore 2007;36(12):1028-1031
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONMycotic aneurysms are associated with high mortality rates and are managed in the local setting with extra-anatomical bypass followed by ligation, exclusion and debridement of the aneurysm. This is the first case of successful endovascular stenting in an immunocompromised patient with Salmonella mycotic aneurysm.
CLINICAL PICTUREA middle-aged man who was HIV positive had Salmonella septicaemia. He developed abdominal pain 5 days after admission and a computed tomography (CT) scan of the abdomen revealed infrarenal aortitis. He developed a mycotic aneurysm 3 weeks later.
TREATMENTHe opted for endovascular stenting and after prolonged antibiotic therapy and negative blood cultures, he underwent the procedure using a Talent stent, with an iliac extension.
OUTCOMEHe was discharged 1 week after stenting and maintained on oral bactrim based on sensitivity. At 1-year follow-up, he remains well symptomatically and CT scan showed no endoleak or collection.
CONCLUSIONEndovascular stenting, though a fairly new procedure, can be successfully deployed even in a mycotic aneurysm in the right setting.
