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Mycotic Aneurysm of Internal Carotid Artery Secondary to Livestock-associated Methicillin-resistant Staphylococcus Aureus Clonal Complex CC398.
Tenezaca-Sari, Angel Xavier; Gil-Sala, Daniel; Escolà-Vergé, Laura; Lung, Mayli; González-López, Juan José; Bellmunt-Montoya, Sergi.
Afiliação
  • Tenezaca-Sari AX; Angiology, Vascular and Endovascular Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.. Electronic address: axtenezaca@hotmail.com.
  • Gil-Sala D; Angiology, Vascular and Endovascular Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  • Escolà-Vergé L; Infectious diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  • Lung M; Microbiology Deparment, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  • González-López JJ; Microbiology Deparment, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  • Bellmunt-Montoya S; Angiology, Vascular and Endovascular Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Ann Vasc Surg ; 78: 379.e7-379.e10, 2022 Jan.
Article em En | MEDLINE | ID: mdl-34481883
ABSTRACT
The aim of this article is to present a case of mycotic aneurysm of internal carotid artery secondary to livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) treated with resection and common-to-internal carotid artery bypass with autologous vein graft in a male pig farmer. A 69-year-old man, pig farmer, with recent dental extraction was admitted with a right cervical pulsatile mass, dysphonia, pain, leukocytosis and elevated C-reactive protein (CRP). Ultrasonography (US) and computed tomography angiography (CTA) showed a 3.9 × 4.5 cm mycotic aneurysm of right internal carotid artery with hypermetabolic uptake in positron emission tomography (PET) scan. Resection of the mycotic aneurysm and a common-to-internal carotid artery bypass with major saphenous vein graft were performed. LA-MRSA clonal complex (CC) 398 was detected in intraoperative samples and antibiotic therapy was changed according to antibiogram. Patient was discharged at the seventh postoperative day and received antibiotic therapy for 6 weeks. US 12 months later showed patency of the bypass without collections. Mycotic aneurysms of internal carotid artery are very infrequent. MRSA isolation is rare, and to the best of our knowledge this is the first case caused by multi-drug resistant LA-MRSA CC398. The treatment includes mycotic aneurysm resection and reconstruction with venous graft bypass plus intensive antibiotic therapy.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Aneurisma Infectado / Artéria Carótida Interna / Sus scrofa / Staphylococcus aureus Resistente à Meticilina Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Aneurisma Infectado / Artéria Carótida Interna / Sus scrofa / Staphylococcus aureus Resistente à Meticilina Idioma: En Ano de publicação: 2022 Tipo de documento: Article