Infectious Aortitis Caused by &lt;i&gt;Salmonella&lt;/i&gt; Dublin Followed by Aneurysmal Dilatation of the Abdominal Aorta

Nakayama, Masafumi; Fuse, Koichi; Sato, Masahito; Okabe, Masaru; Misumi, Shigeki; Yamashina, Akira; Yamamoto, Kazuo; Yoshii, Shinpei; Aizawa, Yoshifusa

doi:10.2169/internalmedicine.51.7937

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…The cases reported in the literature are summarized in Supplementary Table S1 (refs. 22 – 56 ). The clinical features of the 4 cases treated at our hospital and the 53 cases reported in the literature are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

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

Guo

Bai

Yang

et al. 2018

Braz J Med Biol Res

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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.

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Section: Resultsmentioning

confidence: 99%

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

Guo

Bai

Yang

et al. 2018

Braz J Med Biol Res

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“…The associated risk factors for post-stenotic aortic dilation in the previous reports were mainly male gender, bicuspid aortic valve, hypertension and smoking [ 3 , 22 , 23 ]. Aortic dilatation has been linked with inflammatory diseases such as infectious aortitis, Takayasu arteritis, and giant cell arteritis [ 7 , 8 , 24 ]. While levels of several inflammatory biomarkers such as C-reactive protein (CRP) and interleukin (IL)-6 are elevated in patients with thoracic aortic aneurysms, suggesting the effects of systemic inflammation on the pathophysiology [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte-to-monocyte ratio associated with severe post-stenotic aortic dilation in a case–control study

Chen

Yun

et al. 2022

BMC Cardiovasc Disord

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Background Calcific aortic valve stenosis (CAVS) represents a serious health threat to elderly patients. Post-stenotic aortic dilation, a common feature in CAVS patients, might progress into aneurysm and even dissection, potential consequences of CAVS, and predicts a poor prognosis. This study sought to investigate the association of lymphocyte-to-monocyte ratio (LMR), an inflammatory biomarker, with severe post-stenotic aortic dilation in a case–control study in Chinese population. Materials and methods 208 consecutive patients with CAVS were recruited retrospectively in a case–control study in Chinese population, from July 1, 2015 to June 31, 2018. LMR was statistically analyzed using the ROC curve and binary logistic regression analyses for its prognostic value in severe post-stenotic aortic dilation. Results LMR was significantly reduced in patients with severe post-stenotic aortic dilation (2.72 vs. 3.53, p = 0.002 < 0.05) compared to patients without severe post-stenotic aortic dilation. There was an inverse correlation observed between the maximal diameter of ascending aorta and LMR in the overall patients (r = − 0.217, p = 0.002 < 0.05). For post-stenotic aortic dilation, the prevalence of high-LMR group was statistically lower than that of low-LMR group (19.7% vs. 43.9%, p < 0.001). The maximal diameter of ascending aorta was significantly reduced in the high-LMR group (4.35 vs. 4.76, p = 0.003 < 0.05) compared to low-LMR group. Additionally, LMR was identified in the multivariate analysis independently associated with severe post-stenotic aortic dilation (AUC 0.743, 95% CI: [0.573–0.964], p = 0.025). Conclusions This study provided the evidence of an inverse correlation between severe post-stenotic aortic dilation and LMR. LMR is potentially independently associated with severe post-stenotic aortic dilation.

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“…Infectious aortitis is a rare, life-threatening, inflammatory process within the aortic wall caused by microorganisms that can lead to aortic aneurysm and rupture [ 1 ]. 2.6% of abdominal aortic aneurysms are secondary to infectious aortitis [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Infectious Aortitis: A Life-Threatening Endovascular Complication of Nontyphoidal Salmonella Bacteremia

Hakim

Dávila

Amin

et al. 2018

Case Reports in Medicine

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A 65-year-old Japanese man living in the United States presented with pyrexia and chills associated with intermittent lower abdominal and back pain for 5 days. He denied recent travel, rash, diarrhea, or rectal bleeding. Physical examination revealed spiking pyrexia, and routine laboratory tests revealed mild leukocytosis and neutrophilia. Abdominal CT with contrast showed findings highly compatible with aortitis. Comprehensive autoimmune evaluation was negative. Salmonella enterica serotype Enteritidis was isolated from blood cultures. IV antibiotics were administered, but the patient continued to experience low-grade pyrexia and mild leukocytosis, and follow-up abdominal CT showed progressive aortic inflammation. The patient therefore underwent resection of the affected aortic segment with in-situ graft replacement and lifelong suppressive antibiotics. The patient is asymptomatic with no complications at 18 weeks of follow-up. This case report illustrates that patients with infectious aortitis from nontyphoidal Salmonella may (1) present with nonspecific and nonlocalizing symptoms and signs except for sepsis; (2) have diagnostic blood cultures and abdominal CT findings; and (3) typically require aggressive, prolonged IV antibiotic therapy and surgery for potential cure of this life-threatening infection.

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Infectious Aortitis Caused by <i>Salmonella</i> Dublin Followed by Aneurysmal Dilatation of the Abdominal Aorta

Cited by 6 publications

References 18 publications

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

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

Lymphocyte-to-monocyte ratio associated with severe post-stenotic aortic dilation in a case–control study

Infectious Aortitis: A Life-Threatening Endovascular Complication of Nontyphoidal Salmonella Bacteremia

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