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Annals of the Academy of Medicine, Singapore ; : 1028-1031, 2007.
Article in English | WPRIM | ID: wpr-348347

ABSTRACT

<p><b>INTRODUCTION</b>Mycotic aneurysms are associated with high mortality rates and are managed in the local setting with extra-anatomical bypass followed by ligation, exclusion and debridement of the aneurysm. This is the first case of successful endovascular stenting in an immunocompromised patient with Salmonella mycotic aneurysm.</p><p><b>CLINICAL PICTURE</b>A middle-aged man who was HIV positive had Salmonella septicaemia. He developed abdominal pain 5 days after admission and a computed tomography (CT) scan of the abdomen revealed infrarenal aortitis. He developed a mycotic aneurysm 3 weeks later.</p><p><b>TREATMENT</b>He opted for endovascular stenting and after prolonged antibiotic therapy and negative blood cultures, he underwent the procedure using a Talent stent, with an iliac extension.</p><p><b>OUTCOME</b>He was discharged 1 week after stenting and maintained on oral bactrim based on sensitivity. At 1-year follow-up, he remains well symptomatically and CT scan showed no endoleak or collection.</p><p><b>CONCLUSION</b>Endovascular stenting, though a fairly new procedure, can be successfully deployed even in a mycotic aneurysm in the right setting.</p>


Subject(s)
Humans , Male , Middle Aged , Aneurysm, Infected , Drug Therapy , General Surgery , Therapeutics , HIV Infections , Salmonella Infections , Drug Therapy , Microbiology , General Surgery , Salmonella enteritidis , Stents , Trimethoprim, Sulfamethoxazole Drug Combination , Therapeutic Uses
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