RESUMO
Infrapopliteal mycotic aneurysm resulting from endocarditis is rare, with few reported cases in the literature. We describe a case of ruptured mycotic aneurysm involving the infrapopliteal artery in a patient with aortic and mitral endocarditis. Duplex scanning revealed an oval-shaped mass at the infrapopliteal segment, consistent with sacular aneurysm. The aneurysm showed signs of rupture and pseudoaneurysm formation, which was confirmed by angio-MRI and arteriography. The patient was treated by endovascular procedure and remained asymptomatic at the 6-month follow-up.
Assuntos
Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/etiologia , Endocardite/complicações , Endocardite/diagnóstico por imagem , Artéria Poplítea/diagnóstico por imagem , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico por imagem , Adulto , Humanos , Masculino , UltrassonografiaRESUMO
PURPOSE: Report of clinical/multimodal imaging outcomes of patients with syphilitic uveitis alternatively treated with intravenous(IV) ceftriaxone, due to unavailability of penicillin G. METHODS: Chart review of all cases of syphilitic uveitis presenting to Hospital São Geraldo/HC-UFMG and treated with intravenous ceftriaxone, between January and August 2014. Clinical, serological and ophthalmological data were collected. RESULTS: Twelve consecutive patients with syphilitic uveitis receiving IV ceftriaxone were identified. All 24 eyes had active intraocular inflammation on clinical examination. All patients received IV ceftriaxone (2-4 g daily) for 14-21 days, supplemented with oral corticosteroid as needed in 9 patients (75%), after documented clinical response. Improvement in intraocular inflammation was seen in all 24 eyes, with median best-corrected visual acuity (BCVA) increasing from 20/50 to 20/20, after a mean follow-up of 5.3 months. CONCLUSION: IV ceftriaxone may be an effective alternative for treatment of syphilitic uveitis, in the setting of unavailability of penicillin G.