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Infective Endocarditis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
The term mycotic aneurysm is applied to the intracerebral aneurysms which develop in IE and closely resemble berry aneurysms. Subarachnoid and intracerebral haemorrhage follows their rupture. More rarely, large saccular aneurysms occur in the aorta or its major branches. The term mycotic aneurysm covers aneurysms with a number of different pathogenetic mechanisms. It may be as the direct effect of an inflammatory response to viable organisms in the embolus itself or due to an immune-mediated antigen/antibody complex deposition without viable organisms being present. The media is locally destroyed with fibrinoid necrosis (seeFig. 4.31). Emboli lodging in vasa vasorum causing medial infarction in the aortic wall leading to a saccular aneurysm is another postulated mechanism.
Vascular
Published in Michael Gaunt, Tjun Tang, Stewart Walsh, General Surgery Outpatient Decisions, 2018
Duplex USS is the primary investigation, which will confirm the diagnosis, differentiate between true and false aneurysms and provide an accurate estimate of the size and extent of the aneurysm. Also scan the aorta to exclude co-existent AAA disease. Blood cultures are indicated if mycotic aneurysm is suspected.
Endovascular management of splanchnic artery aneurysms
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
The natural history of mycotic aneurysm wall is of painful enlargement and ultimately rupture. The history of atherosclerotic or other types of aneurysms is uncertain, though one could expect progressive enlargement and ultimate rupture like aneurysms in other locations. Rupture rates range from 38 to 50% with associated mortality rates of 30-90%.22
Mycotic aortic and left iliac ruptured aneurysm due to Escherichia Coli: a case report and literature overview
Published in Acta Chirurgica Belgica, 2022
Ali Ballaith, Juliette Raffort, Khalid Rajhi, Benjamin Salucki, Céline Drai, Elixène Jean-Baptiste, Réda Hassen-Khodja, Fabien Lareyre
Although the incidence of mycotic aneurysm is low, the disease can be associated with high rates of morbidity and mortality. Intriguingly, E. Coli has been rarely reported as a causative agent. We reported a case of mycotic aortic aneurysm and ruptured left iliac aneurysm due to E. Coli infection which was secondary to a urinary infection. Post-operative follow-up was complicated by an acute mesenteric ischemia and fecal peritonitis leading to a secondary polymicrobial aortic graft infection. Similar cases should be reported in order to better identify risk factors, prognosis and post-operative outcomes to help to choose the most appropriate therapeutic approach.
Turbulent Flow in a Cavernous Sinus Lesion: Does It Suggest Something?
Published in Neuro-Ophthalmology, 2021
Vaibhav Kumar Jain, Vivek Singh, Akshata Charlotte, Vikas Kanaujia, Kumudini Sharma
A mycotic aneurysm of the intracavernous part of the internal carotid artery is a rare clinical entity with less than 50 published cases according to a clinical review.1 Mycotic aneurysm is synonymous with an infective aetiology and the diagnosis of it can be challenging. Herein, we present a rare case of a mycotic aneurysm that posed a significant diagnostic dilemma and was managed based on careful evaluation of the clinico-radiological findings.
Staphylococcus aureus sepsis and hemoptysis as messengers of a rather impractically located mycotic aneurysm
Published in Acta Chirurgica Belgica, 2023
Elfi Tournaye, Paul Hollering, Dominik De Roover, Karl Dossche, Sven R. W. Vercauteren
The treatment of mycotic aneurysms of the thoracic aorta is mainly guided by clinical experience as there are no large randomized trials available [24]. However, parallels can be drawn from the guidelines on the management of vascular graft infections by the ESVS [10,25]. By default, high doses of antibiotics and surgical debridement are usually opted for, as mycotic aneurysm repair is always advised irrespective of aneurysm size [3,10].