Image of the month: Mycotic aortic arch pseudoaneurysm due to Salmonella enterica

Clin Med (Lond). 2022 Nov;22(6):580-581. doi: 10.7861/clinmed.2022-0404.

Abstract

A 61-year-old man with hypertension and psoriasis, which was treated with adalimumab, was admitted after a 1-month history of fever following a dental implantation. Computed tomography of the chest revealed a pseudoaneurysm in the aortic arch, and blood culture grew Salmonella enterica A diagnosis of mycotic pseudoaneurysm of the aortic arch due to Salmonella was made, and he was treated with cefoperazone-sulbactam. During his hospital stay, he developed hoarseness followed by haemoptysis, and underwent thoracic endovascular aortic repair followed by emergency open surgical repair. However, he died 5 weeks after the surgery due to acute upper gastrointestinal bleeding, which was confirmed as an aortoesophageal fistula by oesophagogastroscopy.

Keywords: Salmonella enterica; aortic arch; mycotic aneurysm; pseudoaneurysm.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / surgery
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Aortic Diseases*
  • Esophageal Fistula*
  • Humans
  • Male
  • Middle Aged
  • Salmonella enterica*