Salmonella aortitis treated with endovascular aortic repair: a case report
1 Clinic of Internal Medicine, Uster Hospital, Brunnenstrasse 42, Uster, CH-8610, Switzerland
2 Division of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
3 Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
Journal of Medical Case Reports 2012, 6:243 doi:10.1186/1752-1947-6-243Published: 15 August 2012
Salmonella is a typical cause of aortitis, which is associated with high morbidity and mortality. In infrarenal disease, besides open surgery, endovascular aortic repair as an alternative treatment has been reported. To the best of our knowledge, we report the first successful endovascular aortic repair documented by necropsy to date.
A 67-year-old Caucasian man presented with low back pain, fever and positive blood cultures for Salmonella Enteritidis. A computed tomography scan showed an enlargement and intramural hematoma of the infrarenal aortic wall; a Salmonella aortitis was suspected and antimicrobial therapy initiated. Because of substantial comorbidities, endovascular aortic repair was favored over open surgery; postoperatively the antibiotic treatment was continued for 12 months. Post-mortem there were neither macroscopic nor microscopic signs of aortitis or graft infection.
We could demonstrate by necropsy that endovascular aortic repair of infrarenal aortitis with prolonged pre- and postinterventional antibiotic therapy for 12 months was a minimally invasive alternative and should be considered in selected clinically stable patients with substantial co-morbidities.