Salmonella Aortitis Causing a Contained Rupture of a Mycotic Infrarenal Abdominal Aortic Aneurysm Successfully Managed With Endovascular Repair.

Mycotic abdominal aortic aneurysms are rare but life-threatening vascular infections. We report a 71-year-old woman with metastatic small-cell lung cancer receiving immunotherapy. She presented with Salmonella bacteremia and was found to have a 5.4-cm eccentric saccular infrarenal abdominal aortic aneurysm with periaortic gas, inflammatory soft tissue, and a large retroperitoneal hematoma consistent with a contained rupture. Emergent endovascular aneurysm repair (EVAR) was performed. She completed six weeks of intravenous ceftriaxone followed by lifelong suppressive antimicrobial therapy. Follow-up imaging demonstrated a patent graft without endoleak. This case highlights the association between non-typhoidal Salmonella bacteremia and infectious aortitis and illustrates the role of EVAR, combined with prolonged antimicrobial therapy, in the management of mycotic abdominal aortic aneurysm with contained rupture.