RESUMEN
We report the first case of a ruptured intracranial aneurysm-related Staphylococcus epidermidis bacteremia in a patient supported by a continuous flow left ventricular assist device (LVAD). Mycotic aneurysms (MAs) are aneurysmal degeneration of the arterial wall as a result of infection. Current recommendations for management of intracranial mycotic aneurysms are based on a few retrospective case studies. There are only a few cases of intracranial MA reported in patients with LVAD infections caused by Pseudomonas aeruginosa and Klebsiella rhinos. Here, we describe the first case of a ruptured intracranial aneurysm caused by a less virulent organism (Staphylococcus epidermidis) and conclude that screening for asymptomatic MA should be strongly considered in patients with persistent LVAD- and implantable cardiac defibrillator pacemaker-associated infections.
Asunto(s)
Aneurisma Infectado/microbiología , Desfibriladores Implantables/efectos adversos , Endocarditis Bacteriana/complicaciones , Corazón Auxiliar/efectos adversos , Aneurisma Intracraneal/microbiología , Infecciones Estafilocócicas/complicaciones , Desfibriladores Implantables/microbiología , Femenino , Corazón Auxiliar/microbiología , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Staphylococcus epidermidisRESUMEN
The efficacy of primary prophylaxis with atovaquone in preventing Toxoplasma reactivation and disease in hematopoietic cell transplant (HCT) recipients is unknown. We describe 2 cases of atovaquone prophylaxis failure in pre-HCT Toxoplasma-seropositive (pre-HCTSP) recipients who underwent allogeneic HCT (allo-HCT) and review the literature on atovaquone prophylaxis in HCT recipients.