Fatal Salmonella Aortitis with Mycotic Aneurysm Rupture
Fatal Salmonella Aortitis with Mycotic Aneurysm Rupture
复制标题
致命性沙门氏菌主动脉炎伴霉菌性动脉瘤破裂
DOI：
10.1097/00000433-200212000-00017
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
J. Barnard
中科院分区：
文献类型：
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作者：
L. Salzberger;D. Cavuoti;J. Barnard
沙门氏菌最常引起无并发症的肠胃炎，但偏爱损伤血管，特别是动脉粥样硬化损伤的血管。腹主动脉最常受影响。沙门氏菌主动脉炎最严重的并发症是真菌性动脉瘤的形成并随后破裂。作者提出的情况下，61岁的男子谁被发现无反应出院后3天从医院治疗沙门氏菌肠胃炎与菌血症。死后检查发现一个破裂的真菌性动脉瘤和一个大的腹膜后血肿。大量革兰氏阴性杆状体嵌入主动脉壁和周围的炎症浸润，与患者先前分离的沙门氏菌相吻合。鉴于腹主动脉瘤破裂最常与动脉粥样硬化相关，从血培养中分离出沙门氏菌，再加上主动脉周围有气体的放射证据，应提高对感染性大动脉炎的怀疑。单独或合并沙门氏菌大动脉炎继发于动脉粥样硬化的致命主动脉瘤破裂不会对死亡方式产生影响，但沙门氏菌感染是可报告的，因此具有公共卫生影响。
Salmonellae most commonly cause uncomplicated cases of gastroenteritis but have a predilection for damaged blood vessels, especially those damaged by atherosclerosis. The abdominal aorta is most frequently affected. The most serious complication of Salmonella aortitis is mycotic aneurysm formation with subsequent rupture. The authors present the case of a 61-year-old man who was found unresponsive at home 3 days after discharge from the hospital for treatment of Salmonella gastroenteritis with bacteremia. Postmortem examination revealed a ruptured mycotic aneurysm with a large retroperitoneal hematoma. Numerous gram-negative rods were embedded in the wall of the aorta and surrounding inflammatory infiltrate, compatible with the patient’s previously isolated Salmonella. Whereas abdominal aortic aneurysm rupture is most commonly associated with atherosclerosis, the isolation of Salmonella from blood cultures, coupled with radiographic evidence of gas surrounding the aorta, should raise the suspicion of infectious aortitis. Whereas fatal rupture of an aortic aneurysm secondary to atherosclerosis alone or in conjunction with Salmonella aortitis will not have an impact on the manner of death, Salmonella infections are reportable and thus have public health implications.