A mycotic aneurysm related to Salmonella Rissen infection: a case report.

BACKGROUND: Salmonella species commonly causes infection in humans and on occasion leads to serious complications, such as mycotic aneurysms. Here, we present the first case reported of a patient with a mycotic aneurysm likely secondary to Salmonella Rissen infection. CASE PRESENTATION: The patient presented with 4 weeks of lower back pain, chills and a single episode of diarrhoea 2 months prior during a 14-day trip to Hong Kong and Taiwan. Magnetic resonance imaging revealed an aneurysmal left internal iliac artery with adjacent left iliacus rim-enhancing collection. A stool culture was positive for Salmonella Rissen ST 469 EBG 66 on whole genome sequencing. The patient underwent an emergency bifurcated graft of his internal iliac aneurysm and was successfully treated with appropriate antibiotics. CONCLUSIONS: This case highlights the importance of considering the diagnosis of a mycotic aneurysm in an unusual presentation of back pain with features of infection.

Endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm: a case report.

BACKGROUND: Infectious aortic aneurysm, defined as a focal dilation of an infectious arterial wall, is an uncommon life-threatening disease. Compared with open surgery, endovascular repair yields acceptable clinical outcomes. However, residual tissue infection may increase the risk of secondary intervention. Here, we present a successful case of endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm. CASE PRESENTATION: A 58-year-old man presented to hospital with a 3-day history of lower back pain radiating to the back associated with fever. The dynamic imaging characteristics revealed rapid progress of infectious abdominal aortic aneurysm with negative blood culture. The patient underwent endovascular repair and salmonella enteritidis was identified through drain culture. CONCLUSIONS: Endovascular procedure and staged drainage can be feasible and effective option in selected cases.

Imaging Inflammation and Infection in the Gastrointestinal Tract.

A variety of seemingly non-specific symptoms manifest within the gastrointestinal (GI) tract, particularly in the colon, in response to inflammation, infection, or a combination thereof. Differentiation between symptom sources can often be achieved using various radiologic studies. Although it is not possible to provide a comprehensive survey of imaging gastrointestinal GI tract infections in a single article, the purpose of this review is to survey several topics on imaging of GI tract inflammation and infections. The review discusses such modalities as computed tomography, positron emission tomography, ultrasound, endoscopy, and magnetic resonance imaging while looking at up-an-coming technologies that could improve diagnoses and patient comfort. The discussion is accomplished through examining a combination of organ-based and organism-based approaches, with accompanying selected case examples. Specific focus is placed on the bacterial infections caused by Shigella spp., Escherichia coli, Clostridium difficile, Salmonella, and inflammatory conditions of diverticulitis and irritable bowel disease. These infectious and inflammatory diseases and their detection via molecular imaging will be compared including the appropriate differential diagnostic considerations.

Multilevel Mycotic Aneurysms Due to Salmonella Infection: Case Report and Review of the Literature.

Infected or mycotic aneurysms (MAs) of the aorta and adjacent arteries are rare and difficult to treat. We report a unique case of a Salmonella serotype enteritidis-induced rapidly expanding aortic and iliac pseudoaneurysm during preoperative workup. Based on the presented case, we postulate that the agressive nature of Salmonella enteritidis MAs should not be underestimated. If postponed intervention is chosen and the patient is managed conservatively with antibiotic therapy to create a window of definitive diagnosis, one should consider close follow-up imaging to observe progression of the pseudoaneurysm. This may prevent the need of acute intervention.

99m Tc-tazobactam, a novel infection imaging agent: Radiosynthesis, quality control, biodistribution, and infection imaging studies.

The radiolabeled drug 99m Tc-tazobactam (99m Tc-TZB) was developed and assessed as an infection imaging agent in Pseudomonas aeruginosa and Salmonella enterica infection-induced animal models by comparing with inflammation induced animal models. Radiosynthesis of 99m Tc-TZB was assessed while changing ligand concentration, reducing agent concentration, pH, and reaction time while keeping radioactivity constant (~370 MBq). Percent labeling of the resulting complex was measured using paper chromatography and instant thin layer chromatography. The analysis of the 99m Tc-TZB complex indicated >95% labeling yield and electrophoresis revealed complex is neutral in nature. The biodistribution study also showed predominantly renal excretion; however liver, stomach, and intestine also showed slight tracer agent uptake. The agent significantly accumulated in Pseudomonas aeruginosa and Salmonella enterica infection induced tissues 3.58 ± 0.26% and 2.43 ± 0.42% respectively at 1 hour postinjection. The inflamed tissue failed to uptake noticeable activity at 1 hour time point. The scintigraphic study results were found in accordance with biodistribution pattern. On the basis of our preliminary results, the newly developed 99m Tc-TZB can be used to diagnose bacterial infection and to discriminate between infected and inflamed tissues.

Salmonella aortitis treated with endovascular aortic repair.

Salmonella aortitis is a known complication of Salmonella infection that usually requires surgical therapy. It is unknown whether endovascular aortic repair (EVAR) is an acceptable alternative to conventional aortic surgery for patients with Salmonella aortitis who are at high risk for perioperative complications. We therefore report 2 cases of Salmonella aortitis treated with EVAR and review the literature to further characterize previously published cases.

A population-based study of the appearances of enteric Campylobacter and non-typhoidal Salmonella infections on computed tomography.

BACKGROUND: Swift identification and diagnosis of gastrointestinal infections are crucial for prompt treatment, prevention of complications, and reduction of the risk of hospital transmission. The radiological appearance on computed tomography could potentially provide important clues to the etiology of gastrointestinal infections. We aimed to describe features based on computed tomography of patients diagnosed with Campylobacter, Salmonella or Shigella infections in South Sweden. METHODS: This was a retrospective observational population-based cohort study conducted between 2019 and 2022 in Skåne, southern Sweden, a region populated by 1.4 million people. Using data from the Department of Clinical Microbiology combined with data from the Department of Radiology, we identified all patients who underwent computed tomography of the abdomen CTA two days before and up to seven days after sampling due to the suspicion of Campylobacter, Salmonella or Shigella during the study period. RESULTS: A total of 215 CTAs scans performed on 213 patients during the study period were included in the study. The median age of included patients was 45 years (range 11-86 years), and 54% (114/213) of the patients were women. Of the 215 CTAs, 80% (n = 172) had been performed due to Campylobacter and 20% (n = 43) due to Salmonella enteritis. CTA was not performed for any individual diagnosed with Shigella during the study period. There were no statistically significant differences in the radiological presentation of Campylobacter and Salmonella infections. CONCLUSION: The most common location of Campylobacter and Salmonella infections was the cecum, followed by the ascending colon. Enteric wall edema, contrast loading of the affected mucosa, and enteric fat stranding are typical features of both infections. The CTA characteristics of Campylobacter and Salmonella are similar, and cannot be used to reliably differentiate between different infectious etiologies.

Mycotic aneurysm of the internal carotid artery.

Mycotic aneurysms of the extracranial carotid artery are rare. We describe a case of a patient with an aneurysm of extracranial internal carotid artery, presented as a swelling at the right submandibular triangle. Carotid angiography revealed a saccular aneurysm. During the operation, an abscess, due to Salmonella, was found around the aneurysm. Ten days later, after the drainage of the pus, new carotid angiography revealed thrombosis of the right internal carotid artery. Two months later, the physical condition of our patient improved.Atherosclerosis, trauma, and many microbial agents are common causes of the aneurysm. The symptoms of the aneurysm may vary according to its size and location. Pain over the aneurysm is a common symptom. Rupture of the aneurysm is the most dramatic complication. Clinical examination, color Doppler ultrasonography, angiography, and computed tomography are the most common diagnostic modalities. Differential diagnosis must be done from other expansive pathologies. Resection of the aneurysmatic sac with restoration of flow is the preferred method of treatment.

Spectrum of imaging findings in Salmonella infections.

OBJECTIVE: Radiologic findings in Salmonella infections are not well described. In most patients, Salmonella infections produce mild and self-limiting clinical manifestations and therefore are treated empirically with antibiotics. Radiologic investigations are usually performed for patients with severe clinical manifestations or complications and for patients with unusual findings. CONCLUSION: This pictorial essay illustrates various imaging findings in culture-proven cases of Salmonella infection, described broadly as common and uncommon manifestations.

Endovascular stent graft repair for a Salmonella-infected aneurysm of thoracic aorta.

Thoracic endovascular aneurysm repair using stent graft has been reported as a feasible and effective treatment for aortic aneurysm. However, its application for treating infected aortic aneurysms is still controversial and less reported. We report a 74-year-old male diabetic patient diagnosed with Salmonella-infected aortic aneurysm, who was successfully treated with endovascular stent graft repair followed by a 2-month course of intravenous antibiotics and long-term oral antibiotic therapy. Sequential computed tomography scans demonstrated the shrinkage of the aneurysm and no evidence of relapse 11 months later.

Abdominal ultrasonographic findings in typhoid fever: a comparison between typhoid patients and those with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis.

Typhoid fever is a major health problem in many developing countries and its clinical features are similar to other types of bacterial enterocolitis. Definitive diagnosis by blood culture requires several days and is often unfeasible to perform in developing countries. More efficient and rapid diagnostic methods for typhoid are needed. We compared the pathological changes in the bowel and adjacent tissues of patients having typhoid fever with those having bacterial enterocolitis using ultrasonography. A characteristic of patients with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis was mural thickening of the terminal ileum; only mild mural swelling or no swelling was observed in patients with typhoid fever. Mesenteric lymph nodes in patients with typhoid fever were significantly more enlarged compared to patients with other types of bacterial enterocolitis. Our findings suggest typhoid fever is not fundamentally an enteric disease but rather resembles mesenteric lymphadenopathy and ultrasound is a promising modality for diagnosing typhoid fever in developing countries.

[Osteomyelitis of the costae caused by salmonella]. / Osteomyelitis der Rippen durch Salmonellen.

Salmonella enterica serotype Enteritidis was detected in a 34-year-old, previously healthy patient who suffered from osteomyelitis of the costae. Radical surgical debridement and antibiotic therapy were able to stop the infection. An abdominal flap and a thoracic flap were used to cover the soft tissue defect.

Imaging Findings in a Case of Bacteremia Caused by Non-Typhoidal Salmonella Associated with a Congenital Venous Malformation.

Non-typhoidal Salmonella infection is a typical food-poisoning disease, which rarely causes bacteremia, except in immunocompromised individuals. We report the case of a healthy adult in whom a varicose vein associated with a lower-leg venous malformation was considered the source of Salmonella bacteremia.

Massive purulent pericardial effusion with ultrasound features of tamponade secondary to non-typhoid Salmonella infection.

Purulent pericardial effusions are rare and represent the most severe form of bacterial pericarditis. The authors present a case of a male in his 40s with a massive purulent pericardial effusion due to non-typhoid Salmonella, who presented with ultrasound features of a cardiac tamponade. Invasive non-typhoid Salmonella cardiac infection is a rare but important consideration in immunocompromised individuals. This of particular concern in sub-Saharan Africa, where there is a high prevalence of HIV-infected individuals.

Holistic Characterization of a Salmonella Typhimurium Infection Model Using Integrated Molecular Imaging.

A more complete and holistic view on host-microbe interactions is needed to understand the physiological and cellular barriers that affect the efficacy of drug treatments and allow the discovery and development of new therapeutics. Here, we developed a multimodal imaging approach combining histopathology with mass spectrometry imaging (MSI) and same section imaging mass cytometry (IMC) to study the effects of Salmonella Typhimurium infection in the liver of a mouse model using the S. Typhimurium strains SL3261 and SL1344. This approach enables correlation of tissue morphology and specific cell phenotypes with molecular images of tissue metabolism. IMC revealed a marked increase in immune cell markers and localization in immune aggregates in infected tissues. A correlative computational method (network analysis) was deployed to find metabolic features associated with infection and revealed metabolic clusters of acetyl carnitines, as well as phosphatidylcholine and phosphatidylethanolamine plasmalogen species, which could be associated with pro-inflammatory immune cell types. By developing an IMC marker for the detection of Salmonella LPS, we were further able to identify and characterize those cell types which contained S. Typhimurium.

Right costophrenic angle abscess due to Salmonella Dublin infection in combination with type 2 diabetes mellitus.

The main manifestations of type 2 diabetes mellitus are excessive drinking, polyphagia, polyuria and wasting or weight loss in a short period of time, but it is rare to have persistent fever of unknown origin as the main manifestation. This case report describes a 68-year-old male patient with type 2 diabetes mellitus presenting with unexplained fever with persistent exacerbation and a cystic lesion in the right costophrenic horn on abdominal computed tomography (CT). A cytoculture examination of the puncture fluid suggested that the infection was due to Salmonella Dublin. The patient was treated with drainage of the abscess in the right costophrenic angle area, which then healed successfully. These findings suggest that Salmonella Dublin infection should be considered when a patient with type 2 diabetes mellitus presents with an unexplained persistent fever. At the same time, CT-guided abscess puncture can be performed to improve the patient's symptoms, aid diagnosis and improve the quality of life.