PDF(Pubmed)
Abstract：
Non-typhoidal Salmonella typically presents with gastroenteritis. However, an invasive Salmonella infection, which may be typically seen in immunocompromised patients, has a propensity for aortic involvement, especially in patients with risk factors for atherosclerosis. Here we present a 60-year-old female with multiple comorbid conditions and currently on immunosuppressants for rheumatoid arthritis, who presented with nausea, vomiting, and fever of three weeks duration and was found to have Salmonella bacteremia. Blood cultures were positive for Salmonella enterica. Computed tomography (CT) abdomen with contrast was concerning for mycotic aortitis. The patient underwent endovascular repair of an aortic ulcer and was treated with a six-week course of ceftriaxone. Mycotic aneurysm is a rare but potentially fatal complication of invasive Salmonella infection. It occurs typically in older men with atherosclerotic risk factors. It mostly presents as fever, back pain, and/or abdominal pain. Our patient was a middle-aged female who presented with non-specific symptoms. CT angiogram is the diagnostic modality of choice and treatment may require surgical vascular repair and long-term antibiotics. A high level of suspicion is needed to diagnose Salmonella-related mycotic aneurysm/aortitis. Early diagnosis and treatment may improve the mortality.
摘要：
非伤寒沙门氏菌通常表现为胃肠炎。然而,侵袭性沙门氏菌感染,这通常可以在免疫受损的患者中看到，有主动脉受累的倾向,尤其是有动脉粥样硬化危险因素的患者。在这里，我们介绍了一名60岁的女性，患有多种合并症，目前正在使用类风湿关节炎的免疫抑制剂，出现恶心的人，呕吐,和发烧三周，被发现有沙门氏菌菌血症。肠道沙门氏菌血培养呈阳性。腹部增强计算机断层扫描（CT）考虑真菌性主动脉炎。该患者接受了主动脉溃疡的腔内修复术，并接受了为期六周的头孢曲松治疗。霉菌性动脉瘤是侵袭性沙门氏菌感染的罕见但潜在致命的并发症。它通常发生在具有动脉粥样硬化危险因素的老年男性中。它主要表现为发烧，背痛,和/或腹痛。我们的患者是一名中年女性，表现出非特异性症状。CT血管造影是选择的诊断方式，治疗可能需要外科血管修复和长期抗生素。诊断沙门氏菌相关性真菌性动脉瘤/主动脉炎需要高度怀疑。早期诊断和治疗可以提高死亡率。
