Intracranial-Intracranial Bypass Using a Y-Shaped Artery Graft for Growing Unruptured Gemella morbillorum Infectious Aneurysm on Artery Supplying Sensory Cortex

Gemella morbillorum- and Capnocytophaga sp.-Related Mycotic Thoracic Aortic Aneurysm and Mediastinal Abscess: An Unusual Case Report, a Treatment Challenge, and a Review of Literature

“…Mediastinal infections are also unusual, complicating a range of 0.4-5% of cardiac surgeries. Staphylococcus aureus is the most common pathogen encountered in both conditions, though polymicrobial infections and less common agents may be seen [1,16,17]. Gemella morbillorum infections are in general very rare [18,19], with some risk factors including IV drug abuse, alcohol abuse, diabetes mellitus, chronic kidney disease, pre-existing valvular or congenital cardiovascular disease, chronic obstructive pulmonary disease, colon cancer, inflammatory bowel diseases, colonoscopies, and steroid use [20][21][22].…”

“…Mycotic aortic aneurysm is an infectious degeneration of the aortic wall which may result from direct local spread, inoculation, bacteremic seeding, or septic embolization, and poses significant morbidity and mortality risks. Mediastinal abscess is a localized purulent infection that may primarily complicate thoracic surgery or trauma [ 1 ]. The genus Gemella , first established in 1961 [ 2 ], has nine species among which G. haemolysans and G. morbillorum are the most important [ 3 , 4 ].…”

“…It was also isolated in about 15 cases of pleural empyema since 1996 [ 3 , 7 , 20 ], mainly related to oesophageal stricture or dysphagia through aspiration [ 3 , 28 ]. It has also been seen with cases of spondylodiscitis [ 14 , 30 ], septic arthritis [ 31 ], meningitis [ 32 ], retropharyngeal abscess [ 33 ], and more rarely mediastinal abscesses [ 33 ], brain abscesses [ 20 , 34 ], and with related mycotic aneurysms sometimes [ 1 , 14 ]. There is one report about a case of fatal Gemella morbillorum descending mediastinitis from Ludwig’s angina precipitated by an infected tooth [ 35 ], and another that described the first case of Gemella morbillorum mediastinitis and osteomyelitis that followed an ultrasound-guided fine needle aspiration of a posterior mediastinal lymph node via transoesophageal endoscopic approach (a relatively similar setting to our patient) [ 36 ], as well as two similar cases following sternal traumatic introduction [ 37 , 38 ].…”

Risk factors of intracranial infection in patients after intracranial aneurysm surgery

“…[ 13 ] Intracranial infection is one of the most serious clinical diseases of the central nervous system, and most common intracranial infections are bacterial infections. [ 14 , 15 ] Intracranial infections are more complicated and difficult to treat. [ 16 ] Long-term infections may affect normal brain nerve function and seriously affect the prognosis of patients.…”

“…In the process of patients with intracranial aneurysm undergoing craniotomy, the blood-brain barrier is vulnerable to severe damage, which greatly increases the risk of intracranial infection [13] . Intracranial infection is one of the most serious clinical diseases of the central nervous system, and most common intracranial infections are bacterial infections [14,15] . Intracranial infections are more complicated and difficult to treat [16] .…”