[Abdominal aortic mycotic aneurysm due to Salmonella: case report and review of literature]. / Aneurisma micótico da aorta abdominal provocado por salmonela: descrição de caso e revisão de literatura.

A 59 year old female patient was admitted to the hospital complaining of lower back pain and fever for four months, with worsening of symptoms during the last two weeks. A painful pulsatile abdominal mass was the only positive sign at her physical examination. Her CT-Scan showed a periaortic hematoma and a rupture of the aortic wall while the Aortography disclosed a false aneurysm below the renal arteries. All blood cultures were negative. The patient was operated on and had her aneurysm resected and her aorta reconstructed with an in situ bifurcated aorto-femoral Dacron graft. The bacteriological examination of the aortic wall revealed a Salmonella type B, which confirmed the clinical hypothesis of abdominal aortic mycotic aneurysm. It was not possible to maintain a prolonged antibiotic therapy and the patient had to be submitted to a second operation three months later because of an infected graft; when the aorto-femoral graft was removed and an axillobifemoral bypass prosthesis was done. After a three years follow-up period the patient is doing well and has no signs of recurrences. We conclude, based on the literature review and our personal experience, that: 1) the symptomatologic triad presented by the patient is highly suggestive of those diagnosis; 2) blood cultures may not be positive; 3) the CT-Scan and aortography are the best examinations for the diagnosis of abdominal aortic mycotic aneurysm; 4) either the in situ or the extra-anatomical arterial reconstruction may be employed with good results. Higher infection rates are reported with the in situ grafts; 5) life-long antibiotic therapy is recommended whatever reconstruction procedure is selected.

Snail control in urban sites in Brazil with slow-release hexabutyldistannoxane and pentachlorophenol.

Slow release formulations of hexabutyldistannoxane (TBTO) and pentachlorophenol (PCP) were tested for the control of Biomphalaria tenagophila in 52 urban sites in Rio de Janeiro. TBTO acted faster and lasted longer than PCP and at 15 g/m(2) it eliminated snails from 76% of the treated sites for 1 year. Water pollution and rate of flow had no significant influence on the molluscicidal properties of either compound, but alkalinity lowered the activity of TBTO. Failure to control snail populations was due mainly to human interference and to the non-treatment of adjacent breeding sites that were temporarily dry and therefore overlooked.