Inflammatory aneurysm of the abdominal aorta infected by Salmonella dublin.

A 66-year-old man was admitted with postprandial abdominal pain, nausea, vomiting, anorexia and night sweating. He also gave a history of intermittent claudication in the left leg and had a pretibial leg ulcer on the same side. He was a heavy smoker. Physical examination revealed a pulsatile tender abdominal mass and a paraumbilical arterial bruit extending to both femoral arteries. Investigations revealed a sedimentation rate of 90 after 1 h, a C-reactive protein of 12.6 mg/d l (normal < 0.5 mg/dl), and moderate renal insufficiency. Ultrasonography confirmed the presence of an infrarenal, fusiform abdominal aortic aneurysm, 10 cm long with a maximum diameter of 5.5 cm. Little intraluminal thrombus was seen. At emergency laparotomy the aneurysm was found to be of the inflammatory type involving the duodenum, gallbladder and left ureter. There was some free intraperitoneal serous fluid. Gram stain of