Mycotic Aneurysm Presenting as Acute Pyelonephritis

Chen, Jiann-Keh; Lin, Jing; Huang, Chiu‐Ching; Yu, Chung-Chieh

doi:10.1081/jdi-120013974

Cited by 3 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The typical clinical symptoms of acute pyelonephritis are fever and low back pain, which are similar to those of infected aneurysm. There are some case reports of infected aneurysm initially diagnosed as acute pyelonephritis [ 20 , 21 ]. It is possible that infected aneurysm occurs secondarily from acute pyelonephritis or acute cholangitis, but in four of our five patients initially diagnosed with pyelonephritis, those diagnoses were not accurate because the urine culture results were negative or inconsistent with the blood culture results.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics and challenges in diagnosing infected aneurysm: a retrospective observational study from a single center in Japan

et al. 2022

View full text Add to dashboard Cite

Background It is challenging to diagnose infected aneurysm in the early phase. This study aimed to describe the clinical and microbiological characteristics of infected aneurysm, and to elucidate the difficulties in diagnosing the disease. Methods Forty-one cases of infected aneurysm were diagnosed in Nagasaki University Hospital from 2005 to 2019. Information on clinical and microbiological characteristics, radiological findings, duration of onset, and type of initial computed tomography (CT) imaging conditions were collected. Factors related to diagnostic delay were analyzed by Fisher’s exact test for categorical variables or by the Wilcoxon rank-sum test for continuous variables. Results Pathogens were identified in 34 of 41 cases; the pathogens were Gram-positive cocci in 16 cases, Gram-negative rods in 13 cases, and others in five cases. Clinical characteristics did not differ in accordance with the identified bacteria. At the time of admission, 16 patients were given different initial diagnoses, of which acute pyelonephritis (n = 5) was the most frequent. Compared with the 22 patients with an accurate initial diagnosis, the 19 initially misdiagnosed patients were more likely to have been examined by plain CT. The sensitivities of plain CT and contrast-enhanced CT were 38.1% and 80.0%, respectively. Conclusions In cases of infected aneurysm, diagnostic delay is attributed to non-specific symptoms and the low sensitivity of plain CT. Clinical characteristics of infected aneurysm mimic various diseases. Contrast-enhanced CT should be considered if infected aneurysm is suspected.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics and challenges in diagnosing infected aneurysm: a retrospective observational study from a single center in Japan

et al. 2022

View full text Add to dashboard Cite

show abstract

“…We report a case of mycotic abdominal aortic aneurysm (MAAA) in hemodialysis patients. Prompt diagnosis is a challenging problem and such aneurysms are often underdiagnosed because of their rarity, and atypical symptoms that mimic pyelonephritis or kidney stones (1,2).…”

mentioning

confidence: 99%