CTICasesSalmonella Mycotic Aortic Pseudoaneurysm
Imaging findings
CT in an elderly diabetic woman with prolonged fever demonstrates aortic wall disruption with extraluminal contrast pooling and periaortic inflammatory stranding consistent with contained aortic rupture or mycotic pseudoaneurysm, with associated left pleural effusion. Follow-up CT after endovascular stent graft repair shows residual periaortic fluid and gas with a small type II endoleak from intercostal arteries.
Key takeaways
Non-typhoidal Salmonella is a well-recognized cause of mycotic (infectious) aortic aneurysm, particularly in elderly or immunocompromised patients with atherosclerotic disease. CT demonstrates aortic wall irregularity, periaortic inflammatory fat stranding, and contained rupture or pseudoaneurysm. Blood cultures positive for Salmonella in the setting of these CT findings are diagnostic. Endovascular stent graft repair combined with lifelong antibiotic suppression has improved outcomes compared to open surgical repair.
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