High incidence of intravascular focus in nontyphoid Salmonella bacteremia in the age group above 50 years:: a population-based study

Questions regarding the relative frequency of vascular complications in nontyphoid Salmonella bacteremia are pending, and the true population-based age-related incidence is not known. We reviewed all cases of nontyphoid Salmonella bacteremia during a 10-year period from 1994 through 2003 in a well-defined population of 492,843 residents in North Jutland County, Denmark. 77 of a total of 111 cases occurred in patients > 50 years old. In this age group, five cases of mycotic aneurysm and two cases of endocarditis were documented, corresponding to a 9% occurrence. The annual incidence rate of endovascular nontyphoid Salmonella infection in this age group was 4.4 per 1,000,000 person years. The mortality was 43% in cases with endovascular infection, and surgical procedures were important for survival. We conclude that in patients older than 50 years, detection of nontyphoid Salmonella bloodstream infection should be followed by examinations for mycotic aneurysms and endocarditis.