• Antimicrobial therapy
• Aortic aneurysm
• Iliac aneurysm
• Infected
• Staphylococcus aureus
• Surgical intervention

• Humans
• Male
• Retrospective Studies
• Female
• Iliac Aneurysm/microbiology
• Iliac Aneurysm/mortality
• Iliac Aneurysm/therapy
• Iliac Aneurysm/diagnosis
• Iliac Aneurysm/surgery
• Aged
• Middle Aged
• Endovascular Procedures
• Aneurysm, Infected/microbiology
• Aneurysm, Infected/mortality
• Aneurysm, Infected/therapy
• Aneurysm, Infected/diagnosis
• Aneurysm, Infected/surgery
• Aged, 80 and over
• Anti-Bacterial Agents/therapeutic use
• Treatment Outcome
• Staphylococcal Infections/microbiology
• Staphylococcal Infections/mortality
• Aortic Aneurysm/microbiology
• Aortic Aneurysm/mortality
• Aortic Aneurysm/therapy
• Aortic Aneurysm/diagnosis
• Aortic Aneurysm/surgery

• bacteremia
• endovascular aortic repair
• endovascular infection
• mycotic aortic aneurysm
• salmonella enterica

Infected aortic aneurysms are uncommon and difficult to treat. We present a case of infected aortic aneurysm with recurrent nontyphoidal Salmonella bacteremia.

A 68-year-old gentleman presented with non-specific symptoms and was found to have nontyphoidal Salmonella bacteremia and was treated with intravenous ceftriaxone. However his condition did not improve, and he developed a multiloculated right pleural effusion. Thoracocentesis was done to drain hemorrhagic pleural fluid. Chest computed tomography demonstrated descending thoracic aorta saccular aneurysm with periaortic hematoma likely due to recent bleed and extending to the right pleural cavity. He was referred to cardiothoracic surgery team and was planned for medical therapy in view of hemodynamic stability and no evidence of active leakage. He completed intravenous antibiotic for 5 wk and refused surgical intervention. Unfortunately, he was admitted twice for recurrent nontyphoidal Salmonella bacteremia. Finally, he agreed for surgical intervention and underwent endovascular aortic repair 3 mo later. Postoperatively, his condition remained stable with no recurrence of infection.

Our case highlights the importance of high index of suspicion of infected aortic aneurysm in patients with Salmonella bacteremia with high-risk factors such as atherosclerosis.

• Infected aneurysm
• Aorta
• Nontyphoidal Salmonella
• Pleural effusion
• Case report

• 16s rDNA sequencing
• MALDI–TOF
• Peptoniphilus harei
• bacteremia
• gram-positive anaerobic cocci

Pulmonary mycotic pseudoaneurysm is a rare complication of bacteremia with high associated mortality. We present a case of a large proximal pulmonary artery pseudoaneurysm as a result of methicillin-sensitive Staphylococcus aureus bacteremia, originating from a tunneled dialysis catheter infection. This case was ultimately managed conservatively with surveillance imaging and a prolonged intravenous antibiotic course, rather than with surgical or interventional management. To our knowledge, this is the first reported case of a mycotic pulmonary pseudoaneurysm due to septic embolization of an infected superior vena cava thrombus.

(1) Background: Although published recommendations are available, the use of antibiotics in non-typhoidal Salmonella (NTS) infections in children is still controversially debated in clinical practice. Patients might even be put at risk, with necessary antibiotic therapy being withheld due to the widespread concern of prolonged post-convalescent shedding. The authors conducted a systematic review to assess whether antibiotic treatment influences fecal excretion or the clinical course in children with NTS infection. (2) Methods: The review was carried out following the PRISMA guidelines. In a Medline database search, studies assessing the influence of antibiotic therapy on excretion and/or the clinical course of NTS infections were selected. Studies reporting on adults only were not considered. Out of 532 publications which were identified during the systematic literature search, 14 publications were finally included (3273 patients in total). Quality and bias assessment was performed using the Newcastle-Ottawa scale (NOS) or the Cochrane risk-of bias tool (ROB-2). (3) Results: Four early studies from decades ago demonstrated a prolongation of intestinal NTS excretion in children after antibiotic treatment, whereas most studies published more recently observed no significant influence, which might be due to having used more “modern” antibiotic regimes (n = 7 studies). Most studies did not describe significant differences regarding the severity and duration of symptoms between untreated patients and those treated with antibiotics. Quality and bias were mainly moderate (NOS) or variable (ROB-2), respectively. (4) Conclusions: There is no substantial evidence of prolonged excretion of NTS in pediatric patients after treatment with newer antimicrobials. Consequently, clinicians should not withhold antibiotics in NTS infection for children at risk, such as for very young children, children with comorbidities, and those with suspected invasive disease due to concerns about prolonged post-convalescent bacterial excretion. In the majority of cases with uncomplicated NTS diarrhea, clinicians should refrain from applying antibiotics.

• antibiotic treatment
• children
• fecal excretion
• non-thyphoidal Salmonella

• Antimicrobial resistance
• Antimicrobial treatment
• Invasive infections
• Non-typhoidal Salmonella
• Sub-Saharan Africa

• Africa South of the Sahara
• Anti-Bacterial Agents/pharmacology
• Anti-Bacterial Agents/therapeutic use
• Drug Resistance, Bacterial/drug effects
• Humans
• Salmonella Infections/drug therapy

• 1153220N Fonds Wetenschappelijk Onderzoek
• Fonds Baillet Latour

Salmonella species commonly causes infection in humans and on occasion leads to serious complications, such as mycotic aneurysms. Here, we present the first case reported of a patient with a mycotic aneurysm likely secondary to Salmonella Rissen infection.

The patient presented with 4 weeks of lower back pain, chills and a single episode of diarrhoea 2 months prior during a 14-day trip to Hong Kong and Taiwan. Magnetic resonance imaging revealed an aneurysmal left internal iliac artery with adjacent left iliacus rim-enhancing collection. A stool culture was positive for Salmonella Rissen ST 469 EBG 66 on whole genome sequencing. The patient underwent an emergency bifurcated graft of his internal iliac aneurysm and was successfully treated with appropriate antibiotics.

This case highlights the importance of considering the diagnosis of a mycotic aneurysm in an unusual presentation of back pain with features of infection.

• Endovascular infection
• Mycotic aneurysm
• Salmonella Rissen

Salmonella infection is most common in patients with infected aortic aneurysm, especially in Asia. When the aortic wall is heavily atherosclerotic, the intima is vulnerable to invasion by Salmonella, leading to the development of infected aortic aneurysm. By using THP-1 macrophage-derived foam cells to mimic atherosclerosis, we investigated the role of three Salmonella enterica serotypes – Typhimurium, Enteritidis, and Choleraesuis – in foam cell autophagy and inflammasome formation. Herein, we provide possible pathogenesis of Salmonella-associated infected aortic aneurysms. Three S. enterica serotypes with or without virulence plasmid were studied. Through Western blotting, we investigated cell autophagy induction and inflammasome formation in Salmonella-infected THP-1 macrophage-derived foam cells, detected CD36 expression after Salmonella infection through flow cytometry, and measured interleukin (IL)-1β, IL-12, and interferon (IFN)-α levels through enzyme-linked immunosorbent assay. At 0.5 h after infection, plasmid-bearing S. Enteritidis OU7130 induced the highest foam cell autophagy – significantly higher than that induced by plasmid-less OU7067. However, plasmid-bearing S. Choleraesuis induced less foam cell autophagy than did its plasmid-less strain. In foam cells, plasmid-less Salmonella infection (particularly S. Choleraesuis OU7266 infection) led to higher CD36 expression than did plasmid-bearing strains infection. OU7130 and OU7266 infection induced the highest IL-1β secretion. OU7067-infected foam cells secreted the highest IL-12p35 level. Plasmid-bearing S. Typhimurium OU5045 induced a higher IFN-α level than did other Salmonella serotypes. Salmonella serotypes are correlated with foam cell autophagy and IL-1β secretion. Salmonella may affect the course of foam cells formation, or even aortic aneurysm, through autophagy.

• Bloodstream infection
• Salmonellosis
• Sickle cell disease

• Abdominal complications
• Cancer
• Chemotherapy
• Colitis
• Diarrhea
• Infection

• Adult
• Communicable Diseases/therapy
• Gastrointestinal Diseases/diagnosis
• Gastrointestinal Diseases/etiology
• Gastrointestinal Diseases/therapy
• Germany
• Hematology/organization & administration
• Hematology/standards
• Humans
• Medical Oncology/organization & administration
• Medical Oncology/standards
• Neoplasms/complications
• Neoplasms/diagnosis
• Neoplasms/therapy
• Practice Guidelines as Topic
• Societies, Medical/organization & administration
• Societies, Medical/standards

• no number AGIHO

• Clinical manifestation
• Emergency department
• Infected aneurysm
• Misdiagnosis
• Salmonella

• coronary aneurysm
• infection
• salmonella bacteremia
• vein graft

• Aneurysm, Infected/diagnosis
• Aneurysm, Infected/microbiology
• Aneurysm, Infected/therapy
• Anti-Bacterial Agents/therapeutic use
• Aortic Aneurysm, Abdominal/diagnosis
• Aortic Aneurysm, Abdominal/microbiology
• Aortic Aneurysm, Abdominal/therapy
• Humans
• Male
• Middle Aged
• Salmonella Infections/diagnosis
• Salmonella Infections/therapy
• Tomography, X-Ray Computed

• Salmonella
• aneurysm
• endarteritis
• thrombophlebitis

Salmonella-associated mycotic aneurysm is a rare, but dreaded, complication of salmonellosis. Immunocompromised and elderly populations are more susceptible to develop this extra-intestinal complication. Salmonella is spread via fecal–oral and vehicle-borne routes. Reptiles, especially small pet turtles, have been linked with an increased risk of Salmonella infection. Diagnosis of mycotic aneurysm is a challenge due to atypical presentations. Recently, widespread use of CT scan imaging to evaluate for unexplained abdominal pain and sepsis has led to early identification of mycotic aneurysms. Antibiotic therapy and surgical intervention are the cornerstones of management. Open surgery has been the gold standard of treatment but is associated with increased morbidity and mortality. A relatively new alternative to open surgery is endovascular aneurysm repair (EVAR). It is comparatively less invasive and is associated with reduced early morbidity and mortality in the setting of mycotic aneurysm. However, there is a risk of late infection. Here, we present a patient with Salmonella mycotic aneurysm initially treated conservatively with antibiotic therapy who later underwent successful interval EVAR with no complications to date. Also included is a brief review of Salmonella-associated mycotic aneurysms.

• Salmonella
• mycotic aneurysm
• review

• Aged
• Aneurysm, Infected/diagnosis
• Aneurysm, Infected/immunology
• Aneurysm, Infected/microbiology
• Aneurysm, Infected/therapy
• Anti-Bacterial Agents/therapeutic use
• Aortic Aneurysm, Thoracic/diagnosis
• Aortic Aneurysm, Thoracic/immunology
• Aortic Aneurysm, Thoracic/microbiology
• Aortic Aneurysm, Thoracic/therapy
• Aortitis/diagnosis
• Aortitis/immunology
• Aortitis/microbiology
• Aortitis/therapy
• Aortography/methods
• Blood Vessel Prosthesis Implantation
• Debridement
• Discitis/microbiology
• Epidural Abscess/microbiology
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell/complications
• Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
• Leukemia, Lymphocytic, Chronic, B-Cell/immunology
• Leukemia, Lymphocytic, Chronic, B-Cell/therapy
• Magnetic Resonance Imaging
• Male
• Risk Factors
• Salmonella Infections/diagnosis
• Salmonella Infections/immunology
• Salmonella Infections/microbiology
• Salmonella Infections/therapy
• Salmonella enteritidis/isolation & purification
• Tomography, X-Ray Computed

• Aneurysm, Infected/complications
• Aneurysm, Infected/diagnosis
• Aortic Aneurysm/complications
• Aortic Aneurysm/diagnosis
• Cervical Vertebrae/diagnostic imaging
• Discitis/complications
• Discitis/diagnosis
• Fatal Outcome
• Femoral Artery
• Fluorodeoxyglucose F18
• Humans
• Iliac Aneurysm/complications
• Iliac Aneurysm/diagnosis
• Lumbar Vertebrae/diagnostic imaging
• Male
• Middle Aged
• Multimodal Imaging/methods
• Popliteal Artery
• Positron-Emission Tomography
• Radiopharmaceuticals
• Sepsis/complications
• Staphylococcal Infections/complications
• Staphylococcal Infections/diagnosis
• Staphylococcus aureus/isolation & purification
• Tomography, X-Ray Computed

• Department of Health

• non-typhoid salmonella
• aplastic anemia

• Anemia, Aplastic/complications
• Anemia, Aplastic/microbiology
• Humans
• Male
• Middle Aged
• Psoas Abscess/etiology
• Psoas Abscess/microbiology
• Salmonella Infections/complications

• Adult
• Aged
• Aged, 80 and over
• Bacteremia/diet therapy
• Bacteremia/mortality
• Female
• Humans
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Prognosis
• Salmonella Infections/drug therapy
• Salmonella Infections/mortality
• Salmonella enteritidis/drug effects
• Salmonella enteritidis/isolation & purification
• Salmonella typhimurium/drug effects
• Salmonella typhimurium/isolation & purification

• Age Factors
• Aged
• Aged, 80 and over
• Aneurysm, Infected/epidemiology
• Aneurysm, Infected/etiology
• Bacteremia/complications
• Bacteremia/epidemiology
• Bacteremia/mortality
• Endocarditis, Bacterial/epidemiology
• Endocarditis, Bacterial/etiology
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Retrospective Studies
• Salmonella/classification
• Salmonella Infections/complications
• Salmonella Infections/epidemiology
• Salmonella Infections/mortality
• Sex Factors

• Adult
• Aged
• Aged, 80 and over
• Aneurysm, Infected/complications
• Aneurysm, Infected/microbiology
• Aneurysm, Infected/mortality
• Aneurysm, Infected/surgery
• Anti-Infective Agents/therapeutic use
• Aortic Aneurysm/complications
• Aortic Aneurysm/microbiology
• Aortic Aneurysm/mortality
• Aortic Aneurysm/surgery
• Blood Vessel Prosthesis Implantation/adverse effects
• Ciprofloxacin/therapeutic use
• Drug Resistance, Multiple, Bacterial
• Female
• Humans
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Prosthesis-Related Infections/drug therapy
• Prosthesis-Related Infections/microbiology
• Retrospective Studies
• Salmonella Infections/drug therapy
• Salmonella Infections/etiology

• Adolescent
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Male
• Salmonella Infections/diagnosis
• Salmonella Infections/drug therapy
• Salmonella Infections/microbiology
• Salmonella enterica/classification
• Salmonella enterica/isolation & purification