# Beyond Gastroenteritis: Successful Management of a Salmonella-Induced Mycotic Aneurysm

## TL;DR

A farmer developed a rare Salmonella infection in his abdominal aorta after a needle injury and required multiple surgeries to survive.

## Contribution

Highlights a rare zoonotic transmission route of Salmonella and its severe vascular complications in agricultural workers.

## Key findings

- Salmonella bacteremia and infected abdominal aortic aneurysm occurred via parenteral transmission.
- The infection led to aortic rupture, bowel necrosis, and kidney failure requiring multiple surgeries.
- Successful recovery was achieved through aggressive surgical and antimicrobial interventions.

## Abstract

Salmonella species are an uncommon cause of mycotic aneurysms and invasive sepsis, with human infection most often acquired through ingestion, and parenteral transmission being exceedingly rare. We describe a middle-aged farmer who developed Salmonella bacteremia and an infected infrarenal abdominal aortic aneurysm following an accidental needle-stick injury while vaccinating cattle. Blood cultures and intraoperative tissue specimens yielded Salmonella species. Despite appropriate targeted antimicrobial therapy, the disease progressed rapidly, resulting in rupture of the abdominal aorta that required emergent aortic ligation and axillo-bifemoral bypass, complicated by bowel ischemia and necrosis necessitating left hemicolectomy, colostomy, subsequent re-resection, and acute kidney failure requiring hemodialysis. After multiple surgical interventions, prolonged intensive care, and extended antimicrobial treatment, the patient eventually stabilized and was discharged in satisfactory condition, underscoring the aggressive nature of Salmonella-associated vascular infections and the need to consider rare zoonotic and occupational transmission routes in agricultural workers.