CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 1, January–April 2023 62 AFRICA Both had mycotic aneurysms due to Salmonella infection. Given the age of the patients, the most likely aetiology was presumed to be infection of a pre-existing atheromatous plaque. No endovascular leakage from the graft or any surrounding secretion was observed in the control CT angiograms performed in both patients after surgery and after discharge. In the early stages of mycotic aneurysm, symptoms are usually absent or non-specific. To date, there are no established guidelines for treating mycotic aneurysms, but practical treatment is a combination of antibiotic therapy and surgery.3 Early detection of a mycotic aneurysm is extremely important, as early initiation of treatment improves long-term survival.17 Overall, the mortality rate of mycotic aneurysms is high (23–31%).18 Surgical options include open resection and endovascular repair; however, the optimal surgical treatment is controversial. Open debridement of a mycotic aneurysm has the advantage of eliminating the infected tissue but is associated with a high risk of mortality (13.3–40%).19 Endovascular repair is considered a less invasive procedure with lower mortality rates, especially in high-risk patients, but the lack of adequate surgical debridement of the infected area is a major disadvantage. This can bring about long-term issues due to direct insertion of a graft into an infected area.4,12 There are also no clear guidelines on the choice or duration of antibiotics. Therefore, each case should be evaluated individually based on the patient’s clinical course, co-morbidities, the microorganism involved, the persistence of the micro-organism, and when the graft material was placed based on the patient’s course. Although there is no clear algorithm, when we look at the literature, long-term antibiotic suppressive therapy is recommended after surgical treatment in order to prevent possible haemothegenous seeding.1,20 In both our patients, there was no focus of infection that could cause bacteraemia. Antibiotherapy was started because of growth of Salmonella enterica in the blood cultures taken before and after the operation. The infection parameters of the patients, who consulted with infectious diseases, were followed up and antibiotherapy was completed in eight weeks. Conclusion Mycotic abdominal aortic aneurysms result in high mortality rates. There is no established algorithm for treatment, which should be designed separately for each patient and carried out with the participation of an infectious diseases specialist. Despite timely intervention, unexpected complications and sepsis may lead to mortality, therefore rigorous clinical management is essential. References 1. 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