Durable Results with In Situ Graft Repair of Ruptured Salmonella Aneurysm in a Patient with Autoimmune Deficiency Syndrome

Abstract We describe a case of a 42-year-old male patient with advanced autoimmune deficiency syndrome (AIDS) (CD4 count of 16 cells/mm3) found to have a ruptured infected infrarenal aortic aneurysm. Emergent in situ repair was performed with a Hemashield Dacron graft (Boston Scientific, Natick, MA). Aortic tissue cultures grew group D Salmonella. Patient was placed initially on intravenous ciprofloxacin followed by lifelong oral levofloxacin and trimethoprim. Over 2 years following repair, he remains asymptomatic, with repair intact and no recurrent infection. This case is the first reported successful long-term repair of a ruptured salmonella infected abdominal aortic aneurysm in the setting of advanced AIDS.

摘要：我们描述了一例42岁男性晚期自身免疫缺陷综合征（艾滋病）患者（CD4细胞计数为16个/立方毫米），其被发现患有破裂的感染性肾下腹主动脉瘤。使用赫马斯希尔德涤纶移植物（波士顿科学公司，马萨诸塞州纳蒂克市）进行了紧急原位修复。主动脉组织培养出D组沙门氏菌。患者最初接受静脉注射环丙沙星治疗，随后终身口服左氧氟沙星和甲氧苄啶。修复后2年多，他仍无症状，修复完好，无感染复发。该病例是首例在晚期艾滋病背景下成功对破裂的沙门氏菌感染性腹主动脉瘤进行长期修复的报道。