Type B Aortic Dissection Secondary to Non-typhoidal Salmonella Aortitis: A Case Report and Literature Review.

Abstract

Infectious aortitis is an uncommon but potentially fatal condition that can lead to aortic dissection or rupture. We describe a case of a 69-year-old female who developed a Stanford type B aortic dissection, presumptively caused by Salmonella, which was successfully managed with thoracic endovascular aneurysm repair (TEVAR) and long-term antibiotics. A literature review of 17 reported cases from 2000 to 2024 of aortic dissection secondary to infectious aortitis was conducted. The most frequently implicated causative organisms were Salmonella and Staphylococcus species. Presenting symptoms were non-specific, such as fever, chest or abdominal pain, and constitutional symptoms. Predisposing factors included hypertension, malignancy, diabetes, atherosclerosis, and hyperlipidemia. The proposed pathogenesis involves bacterial seeding of the aortic wall, leading to enzymatic degradation and structural weakening. Management requires prompt surgical intervention (open or endovascular) based on Stanford dissection type, combined with long-term antibiotic therapy. Early diagnosis is crucial, as infectious aortitis can rapidly progress to life-threatening sequelae like rupture or dissection. Clinicians must maintain a high index of suspicion in at-risk patients presenting with suggestive symptoms or imaging findings.