Introduction and lumbar pain radiating to the right groin. Five years previously he had undergone surgery elsewhere An aortic graft infection is among the most serious for Leriche syndrome and received an aortobifemoral complications of surgical arterial reconstruction, with bypass with a 14×7 Dacron bifurcation graft. No an incidence of 0.4–2.6%, it carries with it significant complications or infections of note arose immediately mortality and morbidity. Aortic graft infections can be or over the ensuing years. caused by many different pathogens. Cultures from On admission to this hospital the patient had a high early graft infections most commonly yield coagulasefever, an increased erythrocyte sedimentation rate and negative Staphylococcus aureus; those from late ina leukocytosis. Physical examination disclosed a painfections more often grow Staphylococcus epidermidis. less, pulsatile mass in the mesogastric region. PeriOther bacteria frequently responsible for graft inpheral pulses were present and groin examination fections are Pseudomonas aeruginosa, Escherichia coli and raised no suspicion of septic complications. Abdominal the Klebsiella species, found in 20% of all cases. The ultrasound scanning suggested the presence of a small Salmonella species – relatively frequent in arteritis and pseudoaneurysm with no evident perigraft fluid colaneurysmal infections – only occasionally cause graft lections, and a small stone in the right ureter. On the infections. In a review including 150 cases of thoracic day after admission, a sudden episode of hypotension or abdominal aortic infections caused by the various developed, with intense lumbar pain. An abdominal Salmonella species over the years 1948 to 1999, the angiographic CT scan disclosed a ruptured pseudomost frequent causative organisms were Salmonella aneurysm involving the proximal anastomosis (Fig. typhimurium and Salmonella enteridis. 1). The patient was therefore referred to the vascular In contrast to primary infections of the large arteries, surgery unit. only a few cases of aortofemoral graft infections due At emergency laparotomy, the right side of the to Salmonella have been described to date. proximal anastomosis appeared to have become detached and the graft was surrounded by pus. The Case Report common body of the graft measured 30 mm in diameter. The right and left graft branches appeared A 62-year-old man was admitted to the Department well incorporated and uninfected as did the femoral of General Surgery for the investigation of pyrexia anastomoses. After clamping of the infrarenal aorta the infected prosthetic graft was entirely removed, the ∗ Please address all correspondence to: M. Taurino, Department of aortic stump was ligated and a right axillobifemoral Surgery, ‘‘Paride Stefanini’’, 1st Chair of Vascular Surgery, University of Rome ‘‘La Sapienza’’, viale del Policlinico 155, 0016 Rome, Italy. bypass was constructed. The postoperative course was