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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While salmonellosis is often considered to affect primarily the gastrointestinal tract, infection at other sites may occur, producing characteristic clinical syndromes. We reviewed cases from our institutions and the literature on focal manifestations of salmonella infections. In the past, most extra-intestinal salmonella infections were caused by S. choleraesuis; however, we found S. typhimurium to be the predominant serotype. The mortality rate for patients in our series was considerably lower than the rate described for focal infections in other reviews. This may in part be due to lower proportion of infections due to S. choleraesuis, improved microbiologic and diagnostic techniques, increased use of ampicillin, and improved surgical techniques. Salmonella endocarditis usually occurs in patients with preexisting heart disease. Unlike other salmonella infections, S. choleraesuis is the most frequent serotype. Salmonella endocarditis is often very destructive, with a fatality rate of 70%. Nonvalvular (mural) endocarditis occurs in one-fourth of patients and survival has not been reported. While antibiotic therapy should be tried initially, if response is not prompt the clinician should look for an associated site of infection (intra- or extra-cardiac abscess), which will often require surgery. Salmonella pericarditis often presents with cardiac or pulmonary symptoms, but typical signs of pericardial disease (pulsus paradoxus, friction rub) or characteristic electrocardiographic changes (low voltage, elevated ST segments) are uncommon. Early diagnosis, before infection involves other areas of the heart, is crucial for survival. In addition to antibiotic therapy, pericardiocentesis or pericardiectomy is required. Salmonella may infect the peripheral or visceral arteries, but the abdominal aorta is the most frequent site of vascular infection. Most patients are men over age 50 with preexisting atherosclerosis of the aorta who do not have a previous history of gastroenteritis. About one-fourth of patients have associated lumbar osteomyelitis. No patients have been reported to survive with medical therapy alone. Specific guidelines for surgical removal of infected aneurysms have been proposed and these (in addition to increased use of ampicillin) may be responsible for higher survival rates in recent years. Due to the high incidence of relapses, postoperative blood cultures should be done routinely. Arterial infection should be considered in any elderly patient with salmonella bacteremia especially with prolonged fever or bacteremia after an "adequate course" of antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Extra-intestinal manifestations of salmonella infections. 330 60

Pathologic evaluations of pigeons dying between September 1984 and August 1985 are reported for a production colony of 1200-1800 White Carneau and Show Racer pigeons ranging in age from hatchlings to 12 years. Infectious diseases were the common causes of death in pigeons younger than 1 year; salmonellosis and nephritis were the common causes in pigeons 1-3 years old; and neoplasia and reproductive organ disorders were the common causes in pigeons older than 3 years. Monthly mortality was 2-4% in pigeons fed a cholesterol-containing diet and 0.9% in those fed noncholesterol-containing pellet diets. The increased deaths in the cholesterol-fed birds were attributed primarily to end-stage renal disease and atherosclerosis with secondary complications. The most frequently observed clinical entity in pigeons younger than 6 months was pseudomembrane formation on the oral and pharyngeal mucosa, termed pseudomembranous stomatitis. The definitive etiologic factor was not determined. Although all affected pigeons had similar gross lesions, the cases fell into one of three subsets, suggestive of bacterial, fungal, or viral etiologies. Chronic nephritis occurring as end-stage renal disease was more severe in pigeons fed a cholesterol-containing diet.
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PMID:Survey of the pathologic findings in a large production colony of pigeons, with special reference to pseudomembranous stomatitis and nephritis. 381 11

The authors have explored the suitability of the Mongolian gerbil as a model in aging research and reviewed data on major factors in gerbil morbidity and mortality. The gerbil is a semi-desert rodent, introduced relatively recently into biomedical research. It is moderately prolific, has a maximum survival of about 208 weeks and is easily maintained. Maternal neglect, fighting and epidemic diseases (Tyzzer's disease, salmonellosis, pneumonia) are potential causes of mortality in gerbil colonies. Obese or breeding gerbils may exhibit hyperadrenocorticism, diabetes, non-lipoid arteriosclerosis and secondary lesions in several organs. There is a high prevalence of spontaneous neoplasms in aged gerbils, especially tumors of the adrenal cortex, ovary and skin. The gerbil is a useful model of experimentally-induced stroke, but has proven unsuitable for studies of cholesterol-induced atherosclerosis. The normal and pathological anatomy of periodontal disease in the gerbil is similar in many respects to that of man.
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PMID:The Mongolian gerbil in aging research. 739 11

A 74-year-old male with atherosclerosis presented with severe nontyphoidal salmonellosis, and received outpatient therapeutic antimicrobial treatment. Nevertheless, within seven days he developed a mycotic aortic aneurysm, a serious but treatable complication. Its surgical management was successful. Rapid formation of mycotic aortic aneurysm represents a rare complication of a common disease, nontyphoidal salmonellosis. Atherosclerosis seems to be an important risk factor. Extensive work-up for mycotic aneurysm by CT-scan in patients older than 50 years, with nontyphoidal Salmonella -positive blood cultures, especially in the presence of risk factors for atherosclerosis, is prudent. However, blood and stool cultures of these patients can be negative in 15% and 35% of cases, respectively. And the results of the blood cultures may be delayed. So it is sensible to extend the previous recommendation to patients older than 50 years, with typical symptoms of nontyphoidal salmonellosis and imminent aneurysmatic rupture, independent of previous results of CT-scans, and blood or stool cultures.
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PMID:Nontyphoidal salmonellosis and mycotic aneurysm: a case report. 1618 1

The mortality of patients with mycotic aneurysms is high, especially in East Asia, and infection by Salmonella species is the most common. Our study aimed to improve prognosis of adult mycotic aneurysms with early diagnosis and accurate treatment. Four adult patients with mycotic aneurysm caused by Salmonella were included and analyzed by single-center retrospective analysis. Cases reported in the literature during the past 10 years were also summarized. The average age of the 4 male patients was 61.25 years, while that of the 53 cases reported in the literature was 65.13 years. Hypertension, diabetes, and atherosclerosis were common complications. Most patients presented fever and experienced pain at the corresponding position of the aneurysm. Laboratory examination found an increased number of white blood cells accompanied by an increase in inflammatory markers. Most aneurysms were found in the abdominal aorta, while the rupture of an aneurysm was the most common complication. The mortality rates were 21.43 and 7.14% after open surgery or endovascular aneurysm repair (EVAR) intervention, respectively. The recurrence rates of infection were 0 and 17.85% for both treatments, respectively. The mortality rate of mycotic aneurysm caused by Salmonella infection was high in middle-aged males with hypertension, diabetes, and atherosclerosis. The possibility of a Salmonella-infected aneurysm should be considered in these high-risk groups presenting chills, fever, chest, and back pain. Open surgery was superior to EVAR treatment in the clearance of infected foci and the reduction of postoperative recurrence. The recurrence of postoperative infection can be prevented by intravenous antibiotic therapy for 6 weeks post-surgery.
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PMID:Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature. 2994 49