Mycotic Aneurysm of Aorta Following Mitral Valve Replacement – A Case Report

The term mycotic aneurysm refers to aneurysm associated with infection by microorganism. Sir William Osler first coined the term mycotic aneurysm in 1885 by disclosing the relation between abnormal cardiac valves and infection with micrococci not with fungi. An 11 years old female from Feni presented with asymptomatic vascular swelling in abdomen referred by a cardiologist.CT angiogram revealed fusiform aneurysm in distal part of abdominal aorta involving ostioproximal part of both common iliac arteries and saccular aneurysm of distal part of superior mesenteric arteries suggestive of mycotic aneurysm. Patient underwent vascular operation aorto biilliac bypass by PTFE graft with excision and ligation of aneurysm of superior mesenteric arteries. Mycotic aneurysm in bacterial endocarditis is rare. It is a challenging job for the cardiologists, infectious disease specialists and vascular surgeon. Time appropriate skilled prompt surgical management can bring smile for both patients and physicians. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12281 Cardiovasc. j. 2012; 5(1): 107-111

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An unusual presentation of mycotic aneurysm of popliteal artery and the challenges faced: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20215158 ◽

2021 ◽

Vol 9 (1) ◽

pp. 214

Author(s):

Obed Manuel Kuruvilla ◽

Arun Narayanapanicker ◽

Anu Tresa Antony

Keyword(s):

Popliteal Artery ◽

Mycotic Aneurysm ◽

Clinical Course ◽

Rare Condition ◽

Bacterial Endocarditis ◽

Autologous Vein ◽

Peripheral Vessel ◽

Autologous Vein Graft ◽

William Osler ◽

Dangerous Condition

Mycotic aneurysm of popliteal artery is a very rare condition, most commonly caused by gram positive organisms. This term was coined by William Osler describing aneurysms associated with bacterial endocarditis. Though cases of peripheral vessel mycotic aneurysm are very rare, it is a dangerous condition as it can go for rupture/ thrombosis. The treatment of choice is resection and revascularization, preferably by using autologous vein graft along with antibiotics. A 35-year-old female who presented with features of cerebrovascular accident, during the course of stay was diagnosed to have mycotic aneurysm of the left popliteal artery. We describe the clinical course, investigation findings and challenges faced in management of the case.

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

Dubai Medical Journal ◽

10.1159/000517222 ◽

2021 ◽

pp. 1-4

Author(s):

Reham Almasoud ◽

Alaaeddin Nwilati ◽

Saeb Bayazid ◽

Mamoun Shafaamri

Keyword(s):

Infectious Disease ◽

Antibiotic Therapy ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Mycotic Aneurysm ◽

Artery Aneurysm ◽

Management Plan ◽

Resected Tissue ◽

Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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SIR 2003 Film Panel Case 2: Tumor Emboli to the Common Iliac Arteries

Journal of Vascular and Interventional Radiology ◽

10.1016/s1051-0443(07)60154-7 ◽

2003 ◽

Vol 14 (5) ◽

pp. 656-658

Author(s):

Danielle B. Leighton ◽

Sun Ho Ahn ◽

Timothy P. Murphy

Keyword(s):

Iliac Arteries ◽

The Common ◽

Tumor Emboli ◽

Common Iliac Arteries

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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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Rothia dentocariosa causing intracranial mycotic aneurysm and ischaemic stroke

BMJ Case Reports ◽

10.1136/bcr-2020-240349 ◽

2021 ◽

Vol 14 (3) ◽

pp. e240349

Author(s):

Eli Kisilevsky ◽

Nataly Pesin ◽

Daniel Mandell ◽

Edward A Margolin

Keyword(s):

Intracranial Aneurysms ◽

Mycotic Aneurysm ◽

Systemic Infection ◽

Bacterial Endocarditis ◽

Medical Assessment ◽

Subacute Bacterial Endocarditis ◽

Brain Aneurysm ◽

High Incidence ◽

Mycotic Aneurysms ◽

Untreated Dental Caries

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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The incidence of iliac aneurysms in patients with abdominal aortic aneurysms: Comparison of four centers in Europe and the USA

VASA ◽

10.1024/0301-1526.33.2.68 ◽

2004 ◽

Vol 33 (2) ◽

pp. 68-71 ◽

Cited By ~ 2

Author(s):

Eugster ◽

Bolli ◽

Pfeiffer ◽

Sandmann ◽

Chuter ◽

...

Keyword(s):

External Iliac Artery ◽

Aortic Aneurysms ◽

Iliac Arteries ◽

Maximal Diameter ◽

Abdominal Aortic ◽

Suprarenal Aorta ◽

Significant Difference ◽

The Usa ◽

Preoperative Ct ◽

Common Iliac Arteries

Background: The purpose of this study was to compare the anatomy of the aortoiliac vessels in patients scheduled for infrarenal abdominal aortic aneurysm (AAA) repair in four different countries. Material and methods: Consecutives series of 100 preoperative CT-scans were evaluated at each center. Diameters of the suprarenal aorta, maximal diameter of the aneurysm, right and left common and external iliac artery as well as the hypogastric arteries were recorded and compared between each center. Results: Configuration of the AAA above bifurcation was similar at each center. The dimensions of the aortic bifurcation and the common iliac arteries were different among the centers. Common iliac arteries with diameters over 25mm were significantly more common at center 1 (p < 0.001, p = 0.002 and p < 0.001). Among centers 2,3 and 4 there was no significant difference in common iliac diameters. Conclusions: Configuration of the iliac arteries in AAA was significantly different for Swiss patients compared to American, Austrian and German patients. Reasons for these differences are unclear, epidemiological or genetic factors may be responsible.

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Variations in the aortic - common iliac bifurcation in man - a cadaveric study

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401703 ◽

2013 ◽

Vol 02 (02) ◽

pp. 056-060

Author(s):

Maneesha Sharma ◽

Tripta Sharma ◽

Richhpal Singh

Keyword(s):

Abdominal Aorta ◽

Abdominal Cavity ◽

Lumbar Vertebra ◽

Anatomical Variations ◽

Iliac Arteries ◽

Medical College ◽

Great Vessels ◽

Exact Position ◽

Vertebral Bodies ◽

Common Iliac Arteries

Abstract Background and aims: The abdominal aorta usually terminates at the level of L4 vertebral body into common iliac arteries. With the present day advancements in vascular surgery and neurological surgeries involving approach to lumbar vertebral bodies, we need to know any variations from this normal course. So, the present study aimed at knowing the anatomical variations in the termination of abdominal aorta and in common iliac arteries which might prove to be of some help in some of such surgeries. Material and methods: The study was conducted on 35 adult (29 males and 6 females) embalmed cadavers obtained from anatomy departments of Govt. Medical college, Amritsar and Gian Sagar Medical college, Ramnagar, Punjab. The abdominal cavity was opened, peritoneum stripped off from aorta at its bifurcation, variations in its termination, common iliac arteries and their branches were carefully observed and recorded. Results: In 54.29% cases the level of aortic bifurcation was found opposite 4th Lumbar vertebra, in the rest it was variable between L3 and L5 vertebra. Conclusions: These variations may lead to some trouble during vertebral surgeries, making it essential to investigate and locate the exact position of great vessels before the commencement of surgery.

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