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Erschienen in: The International Journal of Cardiovascular Imaging 3/2013

01.03.2013

Salmonella mycotic aneurysm: a rare cause of fever and back pain in elderly

verfasst von: Jen-Li Looi, Lily Cheung, Alex Pui-Wai Lee

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 3/2013

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Abstract

An 85-year-old man with history of hypertension presented with fever, cough and abdominal pain. Unfortunately fever and leukocytosis persisted despite treatment. Blood cultures obtained on admission grew Salmonella enteritidis. Subsequently he developed increasing back pain and transoesophageal echocardiography (TOE) was performed, demonstrating a complex ulcer at the aortic arch with multiple small mobile strandlike densities suggestive of vegetation. Contrast thoracic CT scan confirmed an ulcerated atherosclerotic plaque which progressively increasing in size over 3 months despite antibiotics. Therefore, a stent was deployed in view of high risk of perforation and he was placed on prolonged antibiotics. Post-stenting CT scan a few months later showed a patent stent with the aneurysm remained stable in size. Cardiovascular infections develop in approximately 25 % of patients with Salmonella bacteremia. Most patients with Salmonella aortitis have preexisting atherosclerosis at the site of the subsequently infected aneurysm. The diagnosis of S. aortitis can be challenging, because the clinical course may be indolent and the symptoms are nonspecific. A high index of suspicion is required to make the diagnosis of S. aortitis, especially in patients with Salmonella bacteraemia, fever, back pain and/or abdominal pain. This case highlights the usefulness of TOE in the evaluation of diseases involving the thoracic aorta, leading to a successful intervention.
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Metadaten
Titel
Salmonella mycotic aneurysm: a rare cause of fever and back pain in elderly
verfasst von
Jen-Li Looi
Lily Cheung
Alex Pui-Wai Lee
Publikationsdatum
01.03.2013
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 3/2013
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-012-0115-4

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