trimethoprim--sulfamethoxazole-drug-combination and Arteriosclerosis

From 1990 through 1994, we collected information on all cases of mycotic aneurysms due to non-typhi Salmonella that occurred at the Veterans General Hospital in Kaohsiung, Taiwan. All cases of salmonella bacteremia were reviewed to find any additional cases. A total of 16 cases of salmonella mycotic aneurysms occurred. The mortality rate was 100% among the three patients treated with medical therapy alone. Nine (70%) of the 13 patients who received surgical and medical therapy survived. Ten of the 16 cases were due to Salmonella choleraesuis. Diagnosis was established by computed tomography or aortography. Gallium scans were of no diagnostic utility. A culture of blood from a patient with underlying atherosclerosis that is positive for invasive Salmonella should prompt a search for a mycotic aneurysm. Treatment with a third-generation cephalosporin and resection of the infected vessel is usually successful.

Topics: Aged; Ampicillin; Aneurysm, Infected; Anti-Bacterial Agents; Arteriosclerosis; Bacteremia; Cefazolin; Ceftriaxone; Cephalosporins; Ciprofloxacin; Female; Gallium Radioisotopes; Humans; Male; Middle Aged; Mortality; Penicillins; Retrospective Studies; Salmonella; Salmonella Infections; Seroepidemiologic Studies; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination