Mycotic Aneurysm: Case Series

Kota, Albert Abhinay; Sen, Indrani; Selvaraj, Andrew Dheepak; Premkumar, Prabhu; Ponraj, Sam; Agarwal, Sunil

doi:10.4103/0972-0820.152836

Cited by 3 publications

(6 citation statements)

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“…Imaging findings were also similar, though aortic aneurysms tended to be more often a saccular outpouching, likely due to the larger size of the involved vessel; also, aortic aneurysms tended to be associated more frequently with rupture, though this finding did not reach significance [18]. Management options include open surgery and endovascular treatment with long-term antibiotic therapy [2,17]. Open surgery remains one of the best options.…”

Section: Commentsmentioning

confidence: 85%

“…The pathogenic mechanisms involved in the formation of mycotic aneurysms may be septic emboli obstructing the vasa vasorum (common in bacterial endocarditis), neighboring infections reaching the arterial wall, direct bacterial inoculation or bacterial transplantation on an intimal lesion or atheroma plaque. Risk factors for mycotic aneurysms include endothelial lesions caused by atherosclerosis including the presence of aneurysm, history of infection including bacteremia, and iatrogenic arterial lesions [2]. In the literature, there are rare cases that can occur after local treatment with Bacillus Calmette Guerin in bladder cancers [9].…”

Section: Commentsmentioning

confidence: 99%

“…In some cases reports, the authors have described rapidly increased peripheral aneurysms causing compression neuropathy or rupture [15]. The cornerstone of management is to have a strong clinical presumption and positive diagnosis [2]. The classic clinical presentation is a painful, pulsatile, bulky swelling in a patient with general signs such as fever.…”

Section: Commentsmentioning

confidence: 99%

“…Magnetic Resonance Imaging can be an alternative when contrast injection is contraindicated. A saccular aneurysm, rapid enlargement of the original aneurysm and perianeurismal soft tissue mass have been reported in the radiological manifestations typical of mycotic aneurysms [2,17]. To determine whether patients with aortic mycotic aneurysms had difference presenting features and outcomes compared with patients with non aortic mycotic aneurysms including iliac and visceral aneurysms.…”

Section: Commentsmentioning

confidence: 99%

“…At present, the term mycotic aneurysm is used to describe all kinds of infected aneurysms irrespective of causative pathogen [1]. Mycotic aneurysms have an incidence of 1 to 2% [2]. However aortic mycotic aneurysm is associated with mortality rates of 15-50% [3].…”

Section: Introductionmentioning

confidence: 99%

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Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)

Diop¹

2019

CCR

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Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to evaluate the results of the surgery. Materials and Methods: This was a descriptive retrospective study over a 12-years period from December 2005 to February 2018. Results: The total number of our series was 12 cases. The average age at the time of surgery was 37 years old [17-83 years]. There was no predominance of sex. There was a notion of smoking in 3 cases / 12. There was no concept of addiction. Four out of 12 cases had a known concept of heart disease with mitral insufficiency, aortic insufficiency, and complete atrioventricular block. A patient presented in this antecedents a notion of syphilis treated and declared cured. The clinical symptomatology was made of fever in 4 cases out of 12, pain in 11 cases out of 12 with 3 cases of intermittent claudication. The clinical examination had shown a swelling with vascular characters in 11 cases out of 12. Two out of 12 patients had signs of acute limb ischemia. The arterial echodoppler was performed in 11cases out of 12 which had made the diagnosis. The angioscan was performed in 8 cases and showed 4 cases of sacciform aneurysms. All patients benefited from open surgery. The exploration showed 9 cases of false aneurysms with signs of local infection in 5 cases. Flattening with excision of the infected tissues was performed in all cases. The restoration of vascular continuity was immediate in all cases by end-to-end direct anastomosis in 8 cases, 2 cases of extra-anatomical bypass using a dacron tube and two cases of anatomical bypass using the saphenous vein in situ. Early complications were dominated by 2 cases of acute limb ischemia, 2 cases of superficial surgical site infection, 1 case of deep surgical site infection, 1 case of false aneurysm of a common femoral artery and 1 case of hematoma. Follow-up was performed in all patients with an average delay of 14 months [1-60]. There were 1 case of operative mortality and 2 cases of late mortality.

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Section: Commentsmentioning

confidence: 85%

Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)

Diop¹

2019

CCR

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Salmonella Aortitis Causing Primary Aortoenteric Fistula

2021

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Unexpected diagnosis of a neck lump

2019

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A case report of a patient with a right‐sided neck lump initially presenting to his dentist who was subsequently diagnosed with a rare mycotic carotid artery aneurysm. Clinical examination in York out‐patient department led to a high index of suspicion of metastatic squamous cell cancer (SCC). A malignant process was suspected due to the combination of a fixed level 2 neck lump, otalgia and vocal cord palsy. However, a differential diagnosis of an aneurysm became more likely following an MRI scan. The patient subsequently underwent urgent debridement of the carotid artery aneurysm and ligation of the internal carotid artery. Mycotic aneurysms involving the carotid arteries are rare with only around 20 reported cases every decade with a small number of cases reporting dental infection as a potential cause. The definitive diagnosis of a mycotic aneurysm demonstrates how similar the presenting features of a metastatic SCC can be to that of a carotid aneurysm. Despite the low incidence, the importance of considering an aneurysm in the differential diagnosis of neck lumps is highlighted due to possible catastrophic consequences.[Correction statement added on 14 August 2019 after first online publication: The first two sentences of Abstract section were found to be similar and has been updated this version for clarity]

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Mycotic Aneurysm: Case Series

Cited by 3 publications

References 0 publications

Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)

Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)

Salmonella Aortitis Causing Primary Aortoenteric Fistula

Unexpected diagnosis of a neck lump

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