Kidney Week

Abstract: SA-PO1021

Case Report of Nontyphoidal Salmonella Aortitis in a Kidney Transplant Recipient

Session Information

• Transplantation: Clinical - 4
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Muraoka, Suguru, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Suguru Muraoka

• Mochida, Yasuhiro, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Yasuhiro Mochida

• Ishioka, Kunihiro, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Kunihiro Ishioka, MD

• Oka, Machiko, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Machiko Oka, MD

• Moriya, Hidekazu, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Hidekazu Moriya, MD

• Ohtake, Takayasu, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Takayasu Ohtake, MD, PhD

• Hidaka, Sumi, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan

Sumi Hidaka, MD, PhD

Group or Team Name

• Kidney Disease Transplant Center.

Introduction

Immunosuppressive therapy predisposes kidney transplant recipients to various infections. While Salmonella infection after transplantation typically manifests as enteritis or urinary tract infection, there are limited reports of aortitis. We present a case of Salmonella enterica-induced abdominal aortitis.

Case Description

A 49-year-old man with diabetic nephropathy underwent ABO-incompatible living donor kidney transplantation. Five years later, he presented to the emergency department with fever and chills persisting since the previous day. His serum creatinine ranged from 2 to 3 mg/dL. Blood cultures isolated Salmonella enterica, and computed tomography (CT) on day 6 of hospitalization confirmed abdominal aortitis. Conservative management with antibiotics and blood pressure control was initiated, and the aortic diameter was monitored via CT. The maximum aortic diameter reached 27 x 25 mm but subsequently decreased. C-reactive protein (CRP) levels normalized on day 31, and the patient was discharged on day 34.

Discussion

This case highlights infectious aortitis secondary to Salmonella bacteremia post-transplantation. Transplant recipients, particularly those with diabetes, are at heightened risk of Salmonella bacteremia and infectious aortitis due to immunosuppression and atherosclerotic lesions. Given the predominant fecal-oral transmission of Salmonella, dietary counseling for kidney transplant recipients is crucial to mitigate this risk.

PET-CT shows FDG accumulations on a slightly diliated stie of abdominal aorta.