Emphysematous Salmonella aortitis with mycotic aneurysm

Description

A 53-year-old man with history of poorly controlled diabetes mellitus presented with left chest pain radiated to the left shoulder for 3 weeks. On examination, he had low-grade fever, tachypnoea, regular pulse rate at 90/min and blood pressure 140/90 mm Hg. His cardiovascular and chest examinations were otherwise unremarkable.

Initial blood test showed leucocytosis and elevated C reactive protein level. Chest radiograph revealed abnormal soft tissue density silhouette with proximal descending aorta with air-filled collection (figure 1, arrow).

Figure 1

Chest radiograph reveals abnormal soft tissue density silhouette with proximal descending aorta with air-filled collection (arrow).

Contrast-enhanced CT of the aorta (CTA) revealed 1.3x1.5 cm outpouching lesion protruded from the anterior aspect of the proximal descending thoracic aorta (figure 2A, asterisks) with periaortic collection containing multiple air pockets (figure 2A, arrows) surrounding the aortic arch. Salmonella group D bacteraemia was confirmed...

http://ift.tt/2pHM5mx