ABSTRACT
Abstract Candida is a rare cause of infected aortic aneurysms. We report the case of a diabetic patient with end stage kidney disease who underwent repair of a leaking abdominal aortic aneurysm. He was on long-term antibiotic treatment for malignant otitis externa. Candida albicans was isolated from the culture of the excised aneurysm wall. An infected aortic aneurysm due to Candida has not been previously reported in a patient with malignant otitis externa. This case report aims to highlight that Candida should be suspected as a cause of infected aortic aneurysms in patients with debilitation and chronic immunosuppression. Management of such cases can be extremely challenging, especially in resource-poor settings, and we will be touching upon the advantages and disadvantages of various treatment options.
Resumo A cândida é uma causa rara de aneurismas da aorta infecciosos. Relatamos o caso de um paciente diabético com doença renal terminal, que foi submetido a reparo de aneurisma da aorta abdominal com vazamento. Ele estava em tratamento de longo prazo com antibióticos para otite externa maligna. A Candida albicans foi isolada da cultura da parede do aneurisma que sofreu a excisão. Não há relatos prévios de aneurisma da aorta infeccioso causado por cândida em pacientes com otite externa maligna. Este relato de caso visa reforçar que a cândida deve ser uma das suspeitas de causa de aneurisma da aorta infeccioso em pacientes debilitados e com imunossupressão crônica. O manejo desses casos pode ser extremamente desafiador, principalmente em contextos em que os recursos são escassos, e mencionaremos as vantagens e desvantagens das diversas opções de tratamento.
Subject(s)
Humans , Male , Aged , Otitis Externa/complications , Aneurysm, Infected/complications , Aortic Aneurysm, Abdominal/complications , Aneurysm, Infected/etiology , Candida albicans/pathogenicity , Aortic Aneurysm, Abdominal/therapy , Immune Tolerance/immunology , Anti-Bacterial Agents/adverse effectsABSTRACT
Resumen Objetivo: Presentar un caso clínico infrecuente, con una resolución novedosa. Caso Clínico: Paciente con aneurisma micótico de la arteria mesentérica superior manejado satisfactoriamente en forma endovascular. Los aneurismas micóticos viscerales son entidades infrecuentes, con alta morbimortalidad. Es por ello que su manejo debe ser multidisciplinario y considerar diferentes factores al momento de tomar decisiones. En el contexto de la continua mejoría y disponibilidad de las técnicas endovasculares, estas han emergido como una opción terapéutica válida, con posiblemente menos complicaciones. Conclusión: La resolución endovascular del aneurisma micótico visceral es factible, pero su indicación y el manejo completo es aún caso a caso.
Objective: to discuss an infrequent vascular case with a novel resolution. Case Report: Superior mesenteric artery mycotic aneurysm successfully managed with coil embolization. A visceral mycotic aneurysm is an infrequent vascular pathology with high risk of complications and mortality. The endovascular management might offer a treatment option with lower morbimortality rates in selected cases. Conclusion: Endovascular resolution of mycotic visceral aneurysms is both feasible and secure but it must be done in a case to case basis.
Subject(s)
Humans , Male , Aged , Aneurysm, Infected/therapy , Mesenteric Artery, Superior/pathology , Embolization, Therapeutic/methods , Endovascular Procedures/methods , Aneurysm, Infected/etiology , Mesenteric Artery, Superior/diagnostic imagingABSTRACT
Infrapopliteal mycotic aneurysm resulting from endocarditis is rare, with only a few reported cases. We describe the case of a 28-year-old male patient who was suffering with pain and edema in the right leg. The ultrasound revealed an aneurysm of the right tibioperoneal trunk and a deep vein thrombosis (DVT). The patient was admitted and developed acute congestive heart failure, being diagnosed with possible endocarditis. A pseudo-aneurysm was revealed by arteriography. Aggressive antibiotic treatment was initiated, and open surgery confirmed a mycotic pseudo-aneurysm of the tibioperoneal trunk. To our knowledge, this is the 8th case reported of an infected aneurysm in this particular location.
Aneurisma micótico infra-poplíteo resultante de endocardite infecciosa é raro, com apenas alguns casos relatados. Descrevemos o caso de um paciente de 28 anos do sexo masculino que apresentou dor e edema na perna direita. A ultrassonografia demonstrou um aneurisma do tronco tíbio-fibular e trombose venosa profunda do membro inferior direito. O paciente foi internado e desenvolveu falência cardíaca aguda, sendo diagnosticado de endocardite bacteriana. Um pseudo-aneurisma foi evidenciado na arteriografia. Antibioticoterapia agressiva foi iniciada e cirurgia aberta confirmou um pseudo-aneurisma micótico do tronco tibio-fibular. Para o nosso conhecimento, este é o oitavo caso relatado de aneurisma infectado localizado especificamente nesta região.
Subject(s)
Adult , Humans , Male , Aneurysm, Infected/etiology , Endocarditis, Bacterial/complications , Tibial Arteries , Aneurysm, Infected/surgery , Venous Thrombosis/complicationsABSTRACT
We report herein a case successful endovascular treatment with a stent-graft of a rare case of rapidly growing mycotic aneurysm of the left common carotid artery due to acute bacterial endocarditis after eradication of the infection. Infected mycotic aneurysms of the peripheral vasculature have been considered as a contraindication for stent-graft implantation because of the possibility of microorganism spreading to the stent-graft; however, if there is evidence of complete eradication of microorganism and surgery is not an option, stent-graft implantation can be an effective and safe treatment modality for exclusion of the mycotic aneurysm.
Subject(s)
Aged, 80 and over , Female , Humans , Acute Disease , Aneurysm, Infected/etiology , Angioplasty/methods , Carotid Artery Diseases/etiology , Endocarditis, Bacterial/complications , Stents , Treatment OutcomeABSTRACT
A 62-year-old woman has been suffered from cavernous sinus thrombophlebitis which was confirmed by four-vessel angiography, orbit magnetic resonance imaging, and blood culture. Three weeks after recovery of cavernous sinus thrombophlebitis, right eye proptosis and complete third, fourth, and sixth cranial nerve palsies developed. Best-corrected visual acuity decreased to 20/70 in the right eye. Repeat magnetic resonance imaging demonstrated a 1.5-cm-sized mass in the right cavernous sinus, suspicious for mycotic aneurysm. Amphotericin B supplementation was begun and was followed by successful transarterial Guglielmi detachable coil embolization. Four months later, extraocular movement was normalized, and visual acuity improved to 20/25 in the right eye.
Subject(s)
Female , Humans , Middle Aged , Amphotericin B/therapeutic use , Aneurysm, Infected/etiology , Angiography , Antifungal Agents/therapeutic use , Cavernous Sinus Thrombosis/complications , Embolization, Therapeutic/methods , Magnetic Resonance Imaging , Visual AcuityABSTRACT
A 35-year-old, human immunodeficiency virus sero-positive male presented with huge mediastinal mass for evaluation. After contrast enhanced computed tomography (CECT) angiogram, aneurysm of arch of aorta was diagnosed. The patient also proved to be co-infected with syphilis, which is the aetiological cause of aneurysm in this case. The present report highlights the need to suspect, diagnose and treat dual infections in individuals with high risk behaviour.
Subject(s)
Adult , Aneurysm, Infected/diagnosis , Aneurysm, Infected/etiology , Aortic Aneurysm/diagnosis , Aortic Aneurysm/etiology , HIV Antibodies/analysis , HIV Antigens/analysis , HIV Seropositivity/complications , HIV Seropositivity/diagnosis , HIV-1/immunology , Humans , Male , Syphilis, Cardiovascular/complications , Syphilis, Cardiovascular/diagnosis , Tomography, X-Ray ComputedABSTRACT
We report the case of a 49-year-old man that presented with persistent low back pain after being treated for vertebral osteomyelitis. An abdominopelvic CT scan with intravenous contrast showed a mycotic aneurysm of the abdominal aorta. The patient was taken to the operating room where a bypass reconstruction surgery was successfully performed. The history, pathophysiology, most common organisms, risk factors, and clinical presentation of mycotic aneurysms are discussed. The importance of a high index of suspicion for prompt and proper diagnosis and treatment, is emphasized to create awareness about this dreadful complication of vertebral osteomyelitis.
Subject(s)
Humans , Male , Middle Aged , Aneurysm, Infected/etiology , Aortic Aneurysm, Abdominal/etiology , Spinal Diseases/complications , Osteomyelitis/complicationsABSTRACT
Relatamos o caso de uma menina com doença valvar crônica devido à febre reumática que apresentou endocardite infecciosa e duas complicações: acidente vascular cerebral devido à embolia e aneurisma micótico da artéria mesentérica superior.
We report the case of a girl with chronic rheumatic valvar heart disease who developed infeccious endocarditis and two complications, ischemic stroke due to cerebral embolic event and mycotic aneurysm of the superior mesenteric artery.
Subject(s)
Child , Female , Humans , Aneurysm, Infected/etiology , Endocarditis, Bacterial/microbiology , Mesenteric Artery, Superior , Rheumatic Heart Disease/complications , Streptococcal Infections/complications , Aneurysm, Infected/microbiology , Chronic Disease , Echocardiography/methods , Endocarditis, Bacterial/complications , Infarction, Middle Cerebral Artery/diagnosis , Infarction, Middle Cerebral Artery/etiology , Viridans StreptococciABSTRACT
Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
Subject(s)
Aged , Humans , Male , Actinomycosis/complications , Aneurysm, Infected/etiology , Embolization, Therapeutic , Pneumonia, Bacterial/complications , Pulmonary Artery , Treatment OutcomeABSTRACT
Säo apresentados os protocolos de 10 enfermos com endocardite infecciosa (e.i), alguns deles com confirmaçäo clínico-patológica que tornam claras e fidedignas as informaçöes clínicas da história e do exame físico, à luz das respectivas correlaçöes. Ficam demonstradas, nos 10 casos desta doença aqui apresentados, a gravidade da e.i. e a sua complexidade em muitas ocasiöes. As lesöes neurológicas säo achados frequentes nesta patologia (30 a 50 por cento), podendo abrir a cena clínica dos enfermos, aparecer na evoluçäo e/ou mesmo nos períodos de tratamento, de convalescença ou, ainda, tardiamente, meses ou anos após a cura clínica. Quando presentes, os distúrbios neurológicos, dependendo da fase de surgimento e da sua natureza podem complicar ou facilitar o diagnóstico da e.i., mas em todas as circunstâncias o prognóstico é sempre mais sério em sua presença, constituindo-se näo raramente na causa mortis. Qualquer queixa ou achado de alteraçäo neurológica na e.i. obriga-nos à ampla investigaçäo que, no mínimo, deve incluir a realidade de tomografias computadorizadas cerebrais e o estudo angiográfico cerebral completo, à procura de lesöes potencialmente fatais, como aneurisma/s micótico/s cerebral/ais e abscesso/s cerebral/ais, ou ainda na busca de lesöes outras, isoladas ou associadas, como nos pacientes apresentados no presente estudo
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Aneurysm, Infected/etiology , Brain Abscess/etiology , Endocarditis, Bacterial/complications , Neuritis/etiology , Spinal Cord Injuries/etiology , Subarachnoid Hemorrhage/etiology , Thromboembolism/etiology , Vasculitis, Central Nervous System/etiologyABSTRACT
Vascular complications mostly hematomas and false aneurysms are rare after coronary angiography infections problems are even less frequent and a mycotic aneurysm is an extremely rare complication, our patient presented with a mycotic aneurysm of the external iliac artery following percutaneous transluminal coronary angioplasty
Subject(s)
Humans , Male , Coronary Angiography/adverse effects , Aneurysm, Infected/etiology , Iliac Aneurysm/etiology , Iliac Artery/pathologyABSTRACT
Paciente do sexo masculino, 11 anos, portador de estenose aórtica supravalvar, tendo como complicaçäo aneurismas micóticos em aorta ascendente secundários a endocardite bacteriana. Os aneurismas foram diagnosticados através de ecocardiograma-controle ao término de tratamento clínico da endocardite, aparentemente sem intercorrências. A angiografia confirmou o diagnóstico, tendo sido os aneurismas ressecados cirurgicamente. Após 6 meses de cirurgia, o paciente continua bem
Subject(s)
Humans , Male , Child , Aneurysm, Infected/etiology , Endarteritis/microbiology , Endocarditis, Bacterial/complications , Aortic Valve Stenosis/complications , Aneurysm, Infected/surgery , Aneurysm, Infected/diagnosis , Echocardiography, Doppler , Follow-Up Studies , Electrocardiography , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/therapy , Coronary AngiographyABSTRACT
The salient clinical and pathological features are reported of Aspergillus cerebral aneurysms in four young women who had undergone intra-abdominal surgery under spinal anaesthesia and developed clinical features of meningitis 7-16 days postoperatively. The circle of Willis showed ruptured aneurysm in the basilar artery and its branches. The role of iatrogenic factors in the pathogenesis of Aspergillus cerebral aneurysms is highlighted.
Subject(s)
Abdomen/surgery , Adult , Anesthesia, Spinal/adverse effects , Aneurysm, Infected/etiology , Aspergillosis/etiology , Female , Humans , Iatrogenic Disease , Intracranial Aneurysm/etiology , Postoperative Complications , Retrospective StudiesABSTRACT
Paciente do sexo masculino, seis anos de idade, com quadro clínico e ecocardiográfico compátivel com endocardite infecciosa de valva mitral, apresentou como complicaçäo, pseudoaneurisma embolomicótico da artéria femoral comum direita. Submetido a tratamento cirúrgico com a reconstruçäo arterial, evoluiu satisfatoriamente
Subject(s)
Humans , Male , Child , Aneurysm, Infected/etiology , Endocarditis, Subacute Bacterial/complications , Aneurysm, Infected/surgery , Aneurysm, Infected/diagnosis , Angiography, Digital Subtraction , Embolism/etiology , Femoral Artery/surgery , Mitral Valve Insufficiency/surgery , Mitral Valve Insufficiency/complications , Mitral Valve Insufficiency/diagnosisABSTRACT
Los aneurismas micóticos son una complicación infrecuente de los procedimientos diagnósticos invasivos. Se presenta un caso clínico de aneurisma micótico post-cateterismo cardíaco, en una mujer con un síndrome de Marfan. Se analizan las causas y fuentes de infección del cuadro y se propone un esquema terapéutico basado en antibioticoterapia prolongada, resección de la arteria afectada y revascularización extra-anatómica con vena autóloga
Subject(s)
Middle Aged , Humans , Female , Aneurysm, Infected/etiology , Cardiac Catheterization/adverse effects , Staphylococcal Infections , Cloxacillin/therapeutic use , Marfan Syndrome/complicationsABSTRACT
É apresentando um caso de aneurisma com lesöes sifilíticas comunicando-se com o seio de Valsalva aórtico ântero-direito, causando obstruçäo da via de saída do ventrículo direito e deslocamento das artérias coronaria esquerda e descendente anterior. A bolsa aneurismal esférica, näo rota, comunicava-se com o referido seio de Valsalva por pequeno orifício de 7 mm de diâmetro, situado próximo ao orifício da artéria coronária direita. Näo havia lesöes na aorta e a valva era normal. Lesöes sifilíticas foram vistas limitadas à bolsa aneurismal