Rothia dentocariosa causing intracranial mycotic aneurysm and ischaemic stroke

We describe a case of subacute bacterial endocarditis and mycotic brain aneurysm caused by Rothia dentocariosa due to untreated dental caries. R. dentocariosa is a rare cause of endocarditis that has a high incidence of aneurysmal and haemorrhagic complications. All patients with intracranial aneurysms who have signs of systemic infection should be considered to have mycotic aneurysms until proven otherwise. Dental habits should be included in regular medical assessment and dental care should be considered for patients presenting with infectious symptoms.

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Subacute bacterial endocarditis complicated with rupture of an intracranial mycotic aneurysm: A case report

Nihon Naika Gakkai Zasshi ◽

10.2169/naika.76.394 ◽

1987 ◽

Vol 76 (3) ◽

pp. 394-397

Author(s):

Satoshi MONNO ◽

Eiji TSUGANE ◽

Haruhiko IMAI ◽

Ken-ichi FURUKAWA ◽

Shigeyuki KUMAZAWA ◽

...

Keyword(s):

Case Report ◽

Mycotic Aneurysm ◽

Bacterial Endocarditis ◽

Subacute Bacterial Endocarditis

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Endovascular Coil Embolisation of Metachronous Mycotic Aneurysms

Interventional Neuroradiology ◽

10.1177/159101999800400206 ◽

1998 ◽

Vol 4 (2) ◽

pp. 143-150 ◽

Cited By ~ 2

Author(s):

T.C. Roth ◽

J.C. Chaloupka ◽

P.N. Bowers ◽

S.B. Berger ◽

D.A. Wecht ◽

...

Keyword(s):

Therapeutic Strategy ◽

Operative Management ◽

Bacterial Endocarditis ◽

Mitral Insufficiency ◽

Teenage Girl ◽

Coil Embolisation ◽

Subacute Bacterial Endocarditis ◽

Short Term ◽

Mycotic Aneurysms ◽

Vertebrobasilar Circulation

While receiving optimal antibiotic therapy for subacute bacterial endocarditis (SBE), a teenage girl with mild congenital mitral insufficiency presented with two separate episodes of subarachnoid haemorrhage from two rapidly evolving metachronous mycotic aneurysms within the vertebrobasilar circulation. Both aneurysms were successfully treated by endovascular coil embolisation with the GDC system. This permitted at the minimum, successful amelioration of the short term risk of rerupture of the aneurysms, and facilitated operative management of the patient's infected mitral valve. The case further illustrates the utility and effectiveness of endovascular therapy for managing not only the neurovascular sequelae of SBE, but also perhaps the enhanced ability to optimally manage the source of mycotic aneurysms. In addition, the potential limitations and risks of this therapeutic strategy are assessed.

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Mycotic aneurysm of the superior gluteal artery in a patient with bacterial endocarditis: case report and review of the literature

Vascular ◽

10.1258/vasc.2010.cr0225 ◽

2011 ◽

Vol 19 (1) ◽

pp. 47-50 ◽

Cited By ~ 6

Author(s):

Naoki Fujimura ◽

Hideaki Obara ◽

Kenji Matsumoto ◽

Yuko Kitagawa

Keyword(s):

Mycotic Aneurysm ◽

Preoperative Evaluation ◽

Ct Scanning ◽

Bacterial Endocarditis ◽

Review Of The Literature ◽

Safe Alternative ◽

Selective Embolization ◽

Superior Gluteal Artery ◽

Mitral Valve Plasty ◽

Mycotic Aneurysms

Mycotic aneurysm of the superior gluteal artery (SGA) is extremely rare. The review of the literature revealed only five cases of mycotic SGA aneurysms reported to date and none had a concomitant superior mesenteric artery (SMA) aneurysm. We describe a 64-year-old man with mycotic aneurysms of both the SGA and the SMA. The patient was referred to our hospital because of SMA embolism caused by bacterial endocarditis following mitral valve plasty. He was treated conservatively, but monitoring using computerized tomography (CT) scanning showed the development and growth of the SGA and the SMA aneurysms. The SMA aneurysm was resected surgically, and the SGA lesion was treated by means of selective embolization. For the treatment of SGA aneurysms, prompt and precise preoperative evaluation is important. When the anatomical feature and size of the aneurysm is suitable, endovascular treatment may be the first-line treatment, providing an efficacious and safe alternative to traditional surgical repair.

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Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis: A Natural History

Case Reports in Medicine ◽

10.1155/2010/168408 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 16

Author(s):

Isabel Kuo ◽

Theodore Long ◽

Nathan Nguyen ◽

Bharat Chaudry ◽

Michael Karp ◽

...

Keyword(s):

Infective Endocarditis ◽

Natural History ◽

Intracranial Aneurysms ◽

Mycotic Aneurysm ◽

Treatment Modalities ◽

Intraparenchymal Hemorrhage ◽

Retrospective Case ◽

Aneurysm Clipping ◽

History Of ◽

Mycotic Aneurysms

Mycotic aneurysms are a rare cause of intracranial aneurysms that develop in the presence of infections such as infective endocarditis. They account for a small percentage of all intracranial aneurysms and carry a high-mortality rate when ruptured. The authors report a case of a 54-year-old man who presented with infective endocarditis of the mitral valve and acute stroke. He subsequently developed subarachnoid hemorrhage during antibiotic treatment, and a large intracranial aneurysm was discovered on CT Angiography. His lesion quickly progressed into an intraparenchymal hemorrhage, requiring emergent craniotomy and aneurysm clipping. Current recommendations on the management of intracranial Mycotic Aneurysms are based on few retrospective case studies. The natural history of the patient's ruptured aneurysm is presented, as well as a literature review on the management and available treatment modalities.

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