Case Report of Nontyphoidal Salmonella Aortitis in a Kidney Transplant Recipient

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.