Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature

The mortality of patients with mycotic aneurysms is high, especially in East Asia, and infection by Salmonella species is the most common. Our study aimed to improve prognosis of adult mycotic aneurysms with early diagnosis and accurate treatment. Four adult patients with mycotic aneurysm caused by Salmonella were included and analyzed by single-center retrospective analysis. Cases reported in the literature during the past 10 years were also summarized. The average age of the 4 male patients was 61.25 years, while that of the 53 cases reported in the literature was 65.13 years. Hypertension, diabetes, and atherosclerosis were common complications. Most patients presented fever and experienced pain at the corresponding position of the aneurysm. Laboratory examination found an increased number of white blood cells accompanied by an increase in inflammatory markers. Most aneurysms were found in the abdominal aorta, while the rupture of an aneurysm was the most common complication. The mortality rates were 21.43 and 7.14% after open surgery or endovascular aneurysm repair (EVAR) intervention, respectively. The recurrence rates of infection were 0 and 17.85% for both treatments, respectively. The mortality rate of mycotic aneurysm caused by Salmonella infection was high in middle-aged males with hypertension, diabetes, and atherosclerosis. The possibility of a Salmonella-infected aneurysm should be considered in these high-risk groups presenting chills, fever, chest, and back pain. Open surgery was superior to EVAR treatment in the clearance of infected foci and the reduction of postoperative recurrence. The recurrence of postoperative infection can be prevented by intravenous antibiotic therapy for 6 weeks post-surgery.

In situ reconstruction with cryopreserved arterial allograft in mycotic aneurysms or aortoiliac prosthetic grafts infection: a multi-institucional experience

Objective: Aortic prosthetic graft infection remains a highly fatal surgical complication. Recent studies with cryopreserved allografts inthe treatment of vascular graft infection suggest improved clinical outcomes. The purpose of this study was to evaluate the efficacy of cryopreserved aortic allografts in the treatment of infected prosthetic grafts or mycotic aneurysms. Methods: Clinical data of all patients who underwent in situ aortic reconstruction with cryopreserved allografts for either infected aortic prosthetic graft mycotic aneurysms from 1999 to 2003 were reviewed...

Endocarditis infecciosa: complicaciones neurológicas / Infectious endocarditis: neurologic complications

A pesar de los diferentes cambios que ha experimentado la Endocarditis Infecciosa (EI) con los años, los adelantos tecnológicos y la antibioterapia, las complicaciones neurológicas han continuado más o menos igual en el tiempo. Ellas se revisan extensamente en esta publicación, enfatizando la clínica, métodos de exploración y terapéutica actualizada.

¿Baja sensibilidad de los criterios de Durack para el diagnóstico de Endocarditis Infecciosa? : a propósito de un caso clínico / Low sensibility of Durack's criterion for the diagnosis of Infectious Endocarditis : apropos of a case

Se describe el cuadro clínico de una insuficiencia cardíaca progresiva y refractaria al tratamiento médico de un paciente de edad avanzada, con deterioro progresivo lento del estado general (anorexia, pérdida de peso). El único dato orientador del diagnóstico etiológico: Endocarditis Infecciosa (EI), es el antecedente de que, dos meses antes, al paciente se le había implantado un marcapasos. El ecocardiograma muestra en la punta del catéter un aumento de su diámetro y ecogenicidad. Atribuidos dichos cambios a una fibrosis a nivel de la punta del catéter, el estudio bacteriológico post-mortem demuestra que los mismos corresponden a la presencia de una vegetación. La localización atípica de la misma es la razón de la ausencia de aparición de un "nuevo soplo de regurgitación valvular". El hemocultivo seriado demuestra que el agente etiológico es el Clostridium perfringens. El escaso inoculo del germen de una EI afebril, sin aparición temprana de fenómenos vasculares o inmunológicos orientadores.

Endocardite infecciosa e alteraçöes renais / Infectious endocarditis and renal alterations

Säo discutidos os principais fenômenos imunológicos observados na endocardite infecciosa, com ênfase dada às lesöes renais, que têm sido as mais estudads, entre as de natureza imunológica nesta patologia