Mycotic Pulmonary Arterial Aneurysms in an Intravenous Drug User

Abstract

A case of mycotic pulmonary artery aneurysm (PAA) in an intravenous drug user in whom resolution occurred with conservative therapy is described. The natural history of PAA is not well described in the literature. Although PAA is potentially fatal, resolution may occur in patients who do not have hemoptysis. Clinical presentation, diagnosis and management of PAA are reviewed.

Multiple Mycotic Aneurysms of the Pulmonary Arteries Resolving With Conservative Management

“…1,[3][4][5]9 In 5 previously published cases, 2 of the patients were children 1,5 and 3 were adults. 3,4,9 Three patients had multiple MPAAs.…”

“…1,[3][4][5]9 In 5 previously published cases, 2 of the patients were children 1,5 and 3 were adults. 3,4,9 Three patients had multiple MPAAs. 1,4,5 The MPAAs were caused by infective endocarditis, 1,4,5 staphylococcal pneumonia, 3 and an infected cardiac pacemaker.…”

“…3,4,9 Three patients had multiple MPAAs. 1,4,5 The MPAAs were caused by infective endocarditis, 1,4,5 staphylococcal pneumonia, 3 and an infected cardiac pacemaker. 9 The reasons for the decision to manage conservatively included patient refusal of therapeutic embolization, 3 bilateral MPAAs, 4,5 and unsuitable location of MPAAs for surgery.…”

“…There have been very few cases in the literature documenting radiologic resolution of MPAAs by conservative management. 1,[3][4][5][6] We present a case where multiple MPAAs developed in a patient who was suffering from infective endocarditis and cavitating pneumonia. Multislice computed tomography (CT) examinations detected the development of 3 MPAAs.…”

Fever and haemoptysis in an injecting drug user

“…Previous cases have been treated conservatively [9]. Other options include surgery [10] and, depending on the site of the aneurysm, radiological embolisation [11,12].…”