Giant mycotic pulmonary artery aneurysms in a newborn

Abstract

tomography to stress-induced ischemia by single photon emission computed tomography. Am Heart J 2007;153:807 -14. 25. Iskandrian AS, Chae SC, Heo J, Stanberry CD, Wasserleben V, Cave V. Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease. We present the case of a 2-month-old male infant who underwent surgical repair of oesophageal atresia on Day 2 after birth, necessitating a longterm central venous catheter for parenteral nutrition. After 2 months, he presented with fever and haemoptysis. Transthoracic echocardiography identified a large, highly mobile mass located in the right ventricular (RV) outflow tract (Panel A, arrow), which was surgically removed and proved to represent Candida lusitaniae endocarditis (Panel B).As the patient status significantly deteriorated after surgery, a cardiopulmonary computed tomography was performed, revealing the presence of two very large aneurysms in the pulmonary lobar arteries, with a maximum diameter of 4.0 cm for the left pulmonary artery aneurysm (LPAA) and 2.1 cm for the right pulmonary artery aneurysm (RPAA) (Panels C and D), and these dimensions being extremely large for this age. The aetiology of the PAA was the embolization of cardiac vegetations in the pulmonary circulation and subsequent formation of the mycotic aneurysms. Bilateral aneurysm excision was considered too difficult due to their large size and peripheral location; therefore, conservative treatment was applied.The PAAs are very rare findings in the paediatric population. Several cases of the large PAA have been reported in the adult population, most often located in the main pulmonary artery and not in the distal branches as in our case. The distal location of such large aneurysms in the pulmonary artery has not been reported so far. The impressive size of the distal aneurysms and the occurrence in a newborn are unique features of this case.Published on behalf of the

Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis – A case report and a review of the literature

“…HominisCoil embolization-Papaioannou, 2014 [2]F23Drug abuseNS+S. AureusLobectomy+Toganel, 2014 [32]M2 monthsPrevious CVK, endocarditisNS+C. LusitaniaeRemoval of thrombus in right ventricular outflow tract+Luo, 2015 [33]F29PDA, pulmonary endocarditisNS-NSClosure of PDA+Calais, 2017 [34]M36Endocarditis after Ross procedureNS-NSPulmonary valve replacement+Knowles, 2017 [35]F16Operated Tetralogy of Fallot, endocarditisNS-S.…”

Successful Conservative Treatment of Mycotic Pulmonary Artery Aneurysms Caused by MRSA Bacteremia

“…3,4 To our knowledge, this is the only reported case of a child with MPAA caused by MRSA that was cured solely by conservative treatment. [4][5][6][7][8] The major causes of pulmonary artery aneurysm are infections (eg, IE, pneumonia, lung abscess). 1 Here, MPAA appeared after IE, together with septic pulmonary embolisms.…”

“…4 In our literature search (Table 2), we found 5 patients treated conservatively, and 3 of 5 patients were treated successfully. [4][5][6][7][8] In case 1, bilateral MPAAs remained undilated on the basis of CT 2 weeks after the release of conduit stenosis and were treated conservatively. 4 In case 2, left-sided MPAAs had dilated on the basis of CT 18 days after diagnosis and were resected, whereas right-sided MPAAs remained undilated and were treated successfully by conservative therapy.…”

“…5 Patients in cases 3 and 4 had symptoms of hemoptysis and the patient in case 3 had cardiovascular collapse, but both were treated conservatively. 6,7 Resource limitation and MPAA lesion site may have rendered surgery difficult, although they should have been surgically treated. Case 5 is difficult to evaluate because antibiotics were inappropriate.…”