MYCOTIC ANEURYSM OF INTERNAL ILIAC ARTERY CAUSED BY SALMONELLA SPP. INFECTION: A CASE REPORT

Mycotic aneurysm (MA) is an extremely rare disease caused by secondary infection, one of the most common causes is Salmonella spp. A male patient with type 2 diabetes mellitus presented with edema on the left lower limb, fever, abdominal pain radiating to the back, and was suspicious of Deep Vein Thrombosis (DVT). Laboratory examination showed leukocytosis and elevated inflammatory markers such as C-reactive protein and procalcitonin, with Salmonella spp. detected in the blood culture, and the image of MA with thrombus presented on the run-off CT scan with contrast. The patient was scheduled to undergo Endovascular Aneurysm Repair (EVAR) procedure. However, he suddenly had a cardiac arrest on the sixth day of treatment before surgery, caused by suspected pulmonary embolism with suspected DVT. MA has a high mortality rate (around 40%) with a high risk of aneurysm rupture, however, pulmonary embolism has been reported as a cause of death in MA patients with DVT. In addition to rapid diagnosis, aggressive yet adequate therapy, namely surgery and long-term intravenous antibiotics, is crucial.