Massive hematemesis in a child with undiagnosed aortic coarctation and mycotic aneurysm

Grant, Peter; Murala, John Santosh Kumar; Kolli, Rao; Numa, Andrew; Awad, J.; Dilley, A.

doi:10.1016/j.jtcvs.2006.08.027

Cited by 9 publications

(14 citation statements)

References 5 publications

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“…Streptococcus pneumoniae has never been reported to have caused a mycotic aneurysm in a pediatric patient. Most commonly seen etiologic organisms include HACEK organisms ( Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens , and Kingella species), Streptococcus viridans , Staphylococcus aureus , Escherichia coli , Pseudomonas species, Klebsiella species, and fungi 1,2 . In our patient, no organism was found on surgical tissue culture, secondary to prior antibiotic therapy.…”

Section: Discussionmentioning

confidence: 71%

“…In congenital defects, such as aortic coarctation, there is relative hypertension proximal and a turbulent, high‐velocity flow distally. This high‐velocity jet causes endothelial trauma, precipitating an environment conducive for microbial adhesion 1,2 . It has been suggested that distal to the lesion, a lower pressure “sink” is formed, also predisposing the vessel wall to bacterial growth 1 …”

Section: Discussionmentioning

confidence: 99%

“…Mycotic aneurysms are rare in patients with congenital heart disease, but particularly may occur in those with aortic coarctation and abnormal aortic valve. Rapid and accurate identification and diagnosis of mycotic aneurysm is of extreme importance given the significant morbidity and mortality across all age groups 1,2 . The incidence of aortic aneurysm is uncommon before the second decade of life.…”

Section: Introductionmentioning

confidence: 99%

“…Rapid and accurate identification and diagnosis of mycotic aneurysm is of extreme importance given the significant morbidity and mortality across all age groups. 1,2 The incidence of aortic aneurysm is uncommon before the second decade of life. We report a 10-year-old male patient with new diagnosis of coarctation of the aorta and bicuspid aortic valve, who developed a rapidly enlarging mycotic aneurysm.…”

Section: Introductionmentioning

confidence: 99%

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Streptococcus Pneumoniae Causing Mycotic Aneurysm in a Pediatric Patient with Coarctation of the Aorta

Haas

Wilt

Carlson³

et al. 2011

Congenital Heart Disease

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Mycotic aneurysms are rare in patients with congenital heart disease, but may occur in those with aortic coarctation and abnormal aortic valve. Rapid diagnosis of mycotic aneurysm is of extreme importance given the significant reported incidence of morbidity and mortality across all age groups. Aortic aneurysm is uncommon before the second decade of life, and here we report a 10-year-old male patient with new diagnosis of aortic coarctation and bicuspid aortic valve, who developed a rapidly enlarging mycotic aneurysm from Streptococcus pneumoniae. Cardiac magnetic resonance imaging was crucial in making the diagnosis, as well as in follow-up.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Streptococcus Pneumoniae Causing Mycotic Aneurysm in a Pediatric Patient with Coarctation of the Aorta

Haas

Wilt

Carlson³

et al. 2011

Congenital Heart Disease

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“…Most of the aneurysms in this age group are acquired in nature and arise due to infection or trauma, both of which can result in true or false aneurysms. Mycotic aneurysms of the thoracic aorta have been reported secondary to local infections or as complication of aortic coarctation 2‐4 and have presented with hemetemesis 5 or pneumonia 6 . Moreover, aneurysms can follow interventions or surgery performed for coarctation 7,8 .…”

Section: Discussionmentioning

confidence: 99%

Aortic Pseudo-Aneurysm: Cause of Life-Threatening Hemoptysis in a 13-Month-Old Child

Shrivastav¹,

Vaideeswar

Jana³

et al. 2008

Journal of Cardiac Surgery

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Aortic aneurysms and pseudo-aneurysms are a rare occurrence in the pediatric age group. True aneurysms are usually related to infection or to inherited disorders while pseudo-aneurysms occur following trauma or infection. We present a case of a pseudo-aneurysm of the descending thoracic aorta in a 13-month-old child, who presented with life-threatening massive hemoptysis. Though no clear-cut etiologic factor was identified on clinical examination and investigations, presence of neutrophilic infiltration in the wall suggested an infective nature.

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Mycotic aortic aneurysm in a child with aortic coarctation

LeNoir

DeNino

Bradley

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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The recipient was extubated at 5 days after the transplant, and the bronchial and vascular anastomoses appeared to exhibit no kinking and obstruction (Figure 2, C and D). The recipient was discharged from the hospital without oxygen inhalation.The implanted middle lobe remained clear on chest radiography and computed tomography 1 year after the transplant (Figure 1, B and D). The values for the ratio of PaO 2 to inspired oxygen fraction before transplant and 1 year after the transplant were 127 and 384, respectively. Percentage of forced expiratory volume in 1 second values for the donor before and 3 months after the donor operation were 136% and 103%, respectively. The donor and the recipient have been enjoying their healthy lives after the transplant. DISCUSSIONMiddle lobes from adult living donors could contribute to saving small pediatric patients. Limitations of this procedure are as follows: (1) The donor middle lobe should have single arterial, venous, and bronchial branches.Otherwise, the requirement of patch repair may increase the potential surgical risks of the donor operation. (2) An additional contralateral lung transplant may be required as the recipient grows.Living donor lingula or segmental lung transplant might be an alternative strategy.

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Massive hematemesis in a child with undiagnosed aortic coarctation and mycotic aneurysm

Cited by 9 publications

References 5 publications

Streptococcus Pneumoniae Causing Mycotic Aneurysm in a Pediatric Patient with Coarctation of the Aorta

Streptococcus Pneumoniae Causing Mycotic Aneurysm in a Pediatric Patient with Coarctation of the Aorta

Aortic Pseudo-Aneurysm: Cause of Life-Threatening Hemoptysis in a 13-Month-Old Child

Mycotic aortic aneurysm in a child with aortic coarctation

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