Airway stenosis associated with a mycotic pseudoaneurysm of the common carotid artery

Masumoto, Hidetoshi; Shimamoto, M; Yamazaki, Fumio; Nakai, Masanao; Fujita, Shoji; Miura, Yujiro

doi:10.1007/s11748-008-0230-2

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…These should always be suspected in elderly patients with vascular risk factors who present with unexplained bacteraemia. The patient in this case report presented with hoarseness, which is believed to be due to thoracic aortic arch aneurysm causing impingement of the left recurrent laryngeal nerve 26 27. Other clinical presentations of deeper infected aneurysms include gastrointestinal bleeding (due to an aorta-duodenal fistula),28 heart failure or massive haemoptysis 29 30…”

Section: Discussionmentioning

confidence: 87%

Unexpected source ofProteus mirabilisbacteraemia

Nagiah

Badbess

2018

BMJ Case Rep

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Mycotic (infected) aneurysm involving the thoracic aorta is an exceedingly rare and life-threatening condition that is associated with high morbidity and mortality. We report an unusual source of Proteus mirabilis bacteraemia thought to be due to an infected aneurysm in the thoracic aortic arch in an elderly woman. Source of gram-negative bacteraemia is usually isolated to an intra-abdominal or a pelvic source. Proteus bacteraemia from an intrathoracic pathology is very uncommon, and in this case led to a delay in diagnosis. Although an infected aneurysm is a rare source of gram-negative bacteraemia, it must always be considered when common causes of bacteraemia have been ruled out especially in patients with vascular risk factors.

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Section: Discussionmentioning

confidence: 87%

Unexpected source ofProteus mirabilisbacteraemia

Nagiah

Badbess

2018

BMJ Case Rep

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“…Symptoms of an infected aneurysm of the ECA can vary depending on the size and position. These include the following symptoms: a growing, pulsatile cervical mass associated with pain, locally or radiating to the ear, tenderness, fever, dysphonia, dyspnea, and dysphagia (7, 8). Furthermore, cranial- and sympathetic-nerve involvement can lead to Horner's syndrome or parasympathetic-, sensory-, and/or motor dysfunction (7, 9).…”

Section: Discussionmentioning

confidence: 99%

Infected “Mycotic” Aneurysm of the Common Carotid Artery—A Differential Diagnosis to Tumor of the Neck

2018

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Introduction: Infected “mycotic” Aneurysm (IA) of the extracranial carotid artery is a rare condition that can be fatal if mistaken for other pathology. An 83-year-old man presented with a mass on the neck initially suspected malignant. Weeks later it grew rapidly and was found to be an IA, thus requiring acute surgery. Via this case report, we discuss diagnostics and approach when diagnosing masses in relation to vessels of the neck not readily explained.Case Report: After diagnostic imaging and clinical assessment an unknown primary tumor of the neck was suspected. Fine needle aspiration was inconclusive. The patient did not present with any signs of infection or neurological symptoms—only discomfort and pain. Approximately two weeks later, the mass grew and the patient became dysphagic, febrile, and confused. Computed tomography angiography revealed an IA of the right common carotid artery. The patient underwent acute surgery consisting of ligation of the internal and external carotid arteries and resection of the internal jugular vein. The pathogen found was E. coli, supposedly from the bladder after surgical intervention due to polyposis.Conclusion: IA is a very rare entity and can have many etiologies. Since it can be fatal, it is necessary to keep IA in mind when diagnosing masses in relation to vessels of the neck. As shown in this case of a E. coli-induced IA, patients can present with atypical symptoms, on diagnostic imaging it can be mistaken for other pathology, and pathogenesis can be unclear.

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“…[2] The risk factors for carotid artery pseudoaneurysm are diabetes mellitus, Ehlers-Danlos syndrome type IV, mycotic infection, tonsillitis, pharyngeal abscess, previous radiotherapy to the neck, neck dissection, postoperative staphylococcus aureus infection secondary to accidental pharyngocutaneous fistula, carotid endarterectomy, surgery for malignant carotid body tumor pseudoaneurysm and craniofacial trauma. [3][4][5][6][7][8] Also in Behçet disease pseudoaneurysms of the arterial system -most commonly aorta and pulmonary artery-may be seen. [9] Carotid injury should be strongly considered if; (i) the patient's neurologic symptoms are not explained by the head CT; (ii) monoparesis, hemiparesis, or Horner syndrome; (iii) cervical soft tissue injury; or (iv) mandibular or basilar skull fractures.…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Artery Pseudoaneurysm As A Rare Complication Of Labor: A Case Report

Micozkadioglu¹,

Özer²

2008

TUTFD

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Pseudoaneurysms of the carotid artery are rarely encountered in clinical practice. They most likely occur secondary to acute neck trauma, and involve the ICA. [1] Internal carotid artery aneurysms are rare representing 5.6% of all carotid aneurysms. Nearly all aneurysms are acquired and more commonly seen in adults. [2] The traumatic lesion of the ICA presents depending on the wall injury extension. Intimal lesions (incomplete Karotid arter psödoanevrizmaları oldukça nadirdir. Neredeyse tüm anevrizmalar akkizdir ve yetişkin-lerde sık olarak görülmektedir. İnternal karotid arter (İKA) anevrizmaları tüm anevrizmaların %5.6'sını oluşturmaktadır. Doğum İKA anevrizmalarının nadir bir sebebidir. İnternal karotid arter anevrizmalarının tipik semptomları burun ve boğazdan mükerrer minör kanamalar, Horner sendromudur. Kırk dört yaşında multipar bayan hasta bir aydır boynunda şişlik şikayeti ile kliniğimize geldi. Boyundaki şişlik son (11.) doğumundan sonra meydana gelmişti. Hastanın fizik muayenesinde boynunun sol tarafın-da 5x5 cm kitle tespit edildi. Bilgisayarlı tomografisinde İKA duvarından kaynaklanan etrafı hematom ile çevrili psödoanevrizma görüldü. İnternal karotid arter psödoanevrizmalarının tedavisi endovaskü-ler girişim veya İKA ligasyonudur. Hastamızda endovasküler girişim başarılı olmadığından İKA ligasyonu yapılmıştır. İnternal karotid arter psödo-anevrizmasının nadir görülmesi nedeniyle boyun kitlelerinin ayırıcı tanısında düşünülmesi gerektiğinden bu olguyu sunduk. Pseudoaneurysms of carotid artery are rare. Nearly all aneurysms are acquired and more commonly seen in adults. Internal carotid artery aneurysms (ICA) represent 5.6% of all carotid aneurysms. Labor is a rare cause of ICA aneurysm. Repeated minor hemorrhages from the nose and throat, Horner's syndrome are typical symptoms of a pseudoaneurysm of ICA. A 44-year-old multiparaous female presented to our clinic with a complaint of swelling in the neck for one month. The mass in the neck had appeared after her last (11th) labor. Physical examination of the neck revealed a 5x5 cm mass in the left side of the neck. Computed tomography (CT) revealed a pseudoaneurysm originating from the wall of internal carotid artery which was surrounded by a hematoma. The treatment of the pseudoaneurysm of ICA is endovascular intervention or ICA ligation. In our patient endovascular intervention was not successful, therefore ICA was ligated. We report this case because ICA aneurysms are rare, therefore they should be thought in the differential diagnosis of neck masses.

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Airway stenosis associated with a mycotic pseudoaneurysm of the common carotid artery

Cited by 9 publications

References 3 publications

Unexpected source ofProteus mirabilisbacteraemia

Unexpected source ofProteus mirabilisbacteraemia

Infected “Mycotic” Aneurysm of the Common Carotid Artery—A Differential Diagnosis to Tumor of the Neck

Internal Carotid Artery Pseudoaneurysm As A Rare Complication Of Labor: A Case Report

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