Aneurismas infecciosos: incidência, diagnóstico e tratamento

Garcia, Saulo Simões; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen

doi:10.1055/s-0038-1626510

Cited by 1 publication

(2 citation statements)

References 12 publications

(9 reference statements)

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“…However, when present, they are predominantly represented by fever; abdominal, lumbar or thoracic pain; chills; and the presence of a pulsatile mass 20 , 21. Hence, an imaging exam is crucial for the diagnosis, and CT is the method most often used.…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 19 However, when present, they are predominantly represented by fever; abdominal, lumbar or thoracic pain; chills; and the presence of a pulsatile mass. 20 , 21 Hence, an imaging exam is crucial for the diagnosis, and CT is the method most often used. The imaging findings that favor the diagnosis of MA are: (i) atypical localization of the aneurysm: (ii) lack of calcium within the vessel wall; (iii) multilobular aspect; (iv) multifocal or saccular configuration; (v) presence of periaortic gas; (vi) adjacent soft tissue reaction; and (vii) simultaneous presence of osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

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Mycotic aneurysm with aortoduodenal fistula

et al. 2017

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Firstly described in the 19th century by Sir William Osler, the mycotic aneurysm (MA) is a rare entity characterized by an abnormal arterial dilation, which is potentially fatal, and is associated with the infection of the vascular wall. Elderly patients are mostly involved, especially when risk factors like chronic diseases, immunosuppression, neoplasia, and arterial manipulation are associated. The authors report the case of a young male patient diagnosed with an aortic aneurysm of infectious origin in the presence of repeated negative blood cultures. The diagnostic hypothesis was raised when the patient was hospitalized for an inguinal hernia surgery. The diagnosis was confirmed based on imaging findings consistent with mycotic aneurism. The patient was treated with an endovascular prosthesis associated with a long-lasting antibiotic therapy. Five months later, the patient attended the emergency unit presenting an upper digestive hemorrhage and shock, from which he died. The autopsy revealed a huge aneurysm of the abdominal aorta with an aortoduodenal fistula. The histological examination of the arterial wall revealed a marked inflammatory process, extensive destruction of the arterial wall, and the presence of Gram-positive bacteria. This case highlights the atypical presentation of a MA associated with an aortoduodenal fistula. Besides the early age of the patient, no primary arterial disease could be found, and no source of infection was detected.

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Section: Discussionmentioning

confidence: 99%