A rare case of Ruptured Mycotic Infrarenal Aortic Aneurysm Secondary to Salmonella Species
- Author:
Bryan Rene Toledano
1
;
Emily Mae Yap
1
;
Raquel Victoria Ecarma
2
;
Frederick R. Llarena
3
;
Aquileo Rico
4
;
Warren Rondilla
5
;
Joel Paz
6
Author Information
- Publication Type:Case Reports
- Keywords: Typhidot; Case report
- MeSH: Aneurysm, Infected; Salmonella
- From: Philippine Journal of Internal Medicine 2019;57(4):231-234
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Ruptured mycotic aortic aneurysm is a rare and life-threatening condition. An early and proper initiation of antibiotics aside from aneurysmal repair is of paramount importance. The typhidot IgG and IgM may help with this dilemma, especially when the blood culture is negative and during the waiting period for the the aortic sample result.
Case:A 47-year-old male Filipino with type 2 diabetes mellitus presented with severe back pain for one month and intermittent fever for three weeks. Complete blood count showed anemia and leukocytosis with predominance of neutrophils. On computed tomography of the aorta, a segmental calcification and wall discontinuity in the right posterolateral wall of the infrarenal abdominal aorta with heterogenous collection of blood in the retroperitoneal region was seen and aortic rupture secondary to mycotic aneurysm was considered. He underwent emergency abdominal aortic aneurysm repair with debridement, antibiotic lavage, aortoiliac grafting, anastomosis and omental packing. The typhidot IgG and IgM test was positive and was given ceftriaxone 2gm/IV every 24 hours for six weeks. Blood cultures did not reveal significant growth of any pathogen. The aortic wall culture showed heavy growth for salmonella species sensitive to ceftriaxone, confirming and guiding the management. He was then discharged improved.
Conclusion:A mycotic aneurysm secondary to salmonella should be one of the considerations in an adult male diabetic presenting with prolonged fever, abdominal and back pain with or without a tender pulsatile mass. The Typhidot test is an easy and affordable test that allows rapid detection of salmonella infection. Early surgical intervention and antibiotics are the treatment of choice - Full text:8FINAL-2019-015-Rare.pdf
