An Unusual Case of Mycotic Popliteal Aneurysm Presenting as Recurrent Salmonella enteritidis Bacteraemia

Abstract

We describe a patient with a Salmonella enteritidis mycotic aneurysm. A 91-year-old man presented with recurrent episodes of S. enteritidis bacteraemia 2 months apart. During the second presentation, he underwent magnetic resonance imaging of the left lower limb that revealed rupture of the popliteal artery with a popliteal fossa collection. This was aspirated and cultures grew S. enteritidis. He underwent endovascular stenting and received a prolonged course of antibiotics. Popliteal artery mycotic aneurysm should be considered as a differential in patients presenting with unilateral painful leg swelling and bacteraemia from microorganisms with a propensity for endovascular infections. LEARNING POINTS: Our case illustrates a rare and unusual entity of ruptured popliteal mycotic aneurysm in an otherwise common scenario of recurrent nontyphoidal salmonellosis.In patients with recurrent Salmonella bacteraemia, clinicians often perform computed tomography scans to look for extraintestinal sites of involvement; however, this frequently misses any peripherally sited aneurysms, which often do not manifest with any early clinical symptoms.