A 70-year-old diabetic woman was admitted to our hospital with a
complaint of high fever accompanying shaking chills for three days. The
patient had no abdominal symptoms and no history of eating raw food. The
patient’s body temperature was increased to 39 oC, and
blood analysis showed elevations of leukocytes (17,400 /µL) and
C-reactive protein (16.5 mg/dL). Computed tomography revealed air
density spots in the aortic wall (Fig A ), and Salmonella
enteritidis serotype O9 was detected by blood culture. Under a
tentative diagnosis of Salmonella-induced infective aortic aneurysm, the
patient underwent antibiotic treatment with ampicillin/sulbactam. On day
11, the air had disappeared and the aortic wall showed a varicose
deformity, leading to a differential diagnosis of infective aortic
aneurysm (Fig B ). The patient recovered completely with 8-week
antibiotic therapy without any operation.
Cases of infective aortic aneurysms account for only about 1% to 3% of
total cases of aortic aneurysm. However, the case fatality has been
reported to be as high as 18 percent in two years1,
and an early diagnosis is essential. Salmonella species are known
as a common pathogen of the crucial infection2, and so
clinicians should pay attention to the development of the disease.