A Case of Mycotic Aneurysm due to a Salmonella Infection in an Elderly Patient with Low Back Pain

Pei-Xuan Liw¹, Jun-Jun Yeh¹, Hui-Chu Tsai² and Ya-Chi Cheng¹

Mycotic or infected aneurysms are abnormal dilatations of the vasculature due to an infectious process. Mycotic aneurysm possesses life-threatening complications, including aneurysm rupture, severe sepsis, and focal periaortic infection. Symptoms are usually mild and non-specific during the initial course of the disease. Thus early diagnosis and management of mycotic aneurysm might be difficult.
In this article, we report a case of mycotic aneurysm due to a Samonella infection in a 78-year old man with a history of alcohol consumption who presented
with symptoms of fever, chills, and low back pain. Laboratory examinations showed evidence of infection, while abdominal computed tomography revealed a mycotic aneurysm prior to the iliac bifurcation with mild perifocal fat stranding. The management included initial empirical antibiotics, with subsequent surgical intervention arranged. Trans-arterial embolization (TAE) with graft stenting and embolization as well as femoral-femoral bypass were conducted after informed consent was obtained.
Early diagnosis of mycotic aneurysm is challenging due to the unspecific symptoms mentioned. An infected aneurysm may masquerade as urolithiasis, renal
abscess or acute gastroenteritis in the elderly. Hence, mycotic aneurysm should always be considered as a differential diagnosis in aged patients with low back pain, especially in patients with predisposing aortic aneurysm risk factors.
(Taiwan J Fam Med 2023; 33: 115-120) DOI: 10.53106/168232812023063302006

Key words: elderly patient, low back pain, mycotic aneurysm, Salmonella

沙門氏菌感染造成感染性動脈瘤以老年人下背痛表現之案例報告

廖佩炫¹ 葉俊濬¹ 蔡惠曲² 鄭雅綺¹