Mycotic aneurysms: a case report, clinical review and novel imaging strategy

Fisk, Marie; Peck, L F; Miyagi, Kazufumi; Steward, Michael; Lee, S F; MacRae, Martin; Morris-Jones, Stephen; Zumla, Alimuddin; Marks, Daniel

doi:10.1093/qjmed/hcq240

Cited by 58 publications

(69 citation statements)

References 63 publications

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“…5 Mycotic aneurysms remain rare and are usually associated with salmonellosis, disseminated TB and/or HIV infection. 6 HDCTs associated with multiple aneurysms include vascular EDS, Loeys-Dietz syndrome (LDS), pseudoxanthoma elasticum (PXE) and arterial tortuosity syndrome (ATS).…”

Section: Discussionmentioning

confidence: 99%

A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease

Jones

Choong

Canham

et al. 2015

annals

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We report two patients who presented with extensive aneurysmal disease, in association with minimal external physical signs. Patient 1 remained genetically undiagnosed despite multiple structural, biochemical and genetic investigations. He made a good recovery following surgery for popliteal and left axillary artery aneurysms. Patient 2 was diagnosed with vascular type Ehlers-Danlos syndrome, associated with a high degree of tissue and blood vessel fragility, and is being managed conservatively. Early multidisciplinary assessment of such patients facilitates accurate diagnosis and management. The presence of multiple arterial aneurysms is relatively rarely described, and has been previously reported in association with autoimmune vasculitis, infection and a small number of heritable disorders of connective tissue (HDCTs).1 Vascular type Ehlers-Danlos syndrome (EDS) carries a high risk of morbidity and mortality associated with operative and intravascular procedures. 2 For this reason, the identification of individuals with a potential underlying genetic diagnosis is important for surgical planning. Both patients we present had no prior genetic diagnosis. We outline the differential diagnoses for patients with multiple aneurysms and discuss relevant HDCTs. Case 1A 54-year-old Sri Lankan man presented with painful, pulsatile, bilateral axillary masses. He had last visited a tuberculosis (TB) endemic area 13 years previously and had a prior diagnosis of latent TB, with a positive Mantoux test (22mm) 18 months before his presentation. There was no history of claudication or rest pain. Popliteal aneurysms were palpable but pedal pulses were strong, with no evidence of distal embolism or ischaemia.Computed tomography angiography revealed aneurysms throughout the arterial tree, including both axillary arteries (Fig 1). Diffuse and unexplained aneurysms prompted urgent referral for a genetic and infectious disease review. Inflammatory, infective and autoimmune differential diagnoses were considered but serological and positron emission tomography screening and antineutrophil cytoplasmic antibody serology were negative. Although the patient had raised immunoglobulin E titres, Strongyloides was also excluded. He was negative for human immunodeficiency virus (HIV). He was treated with standard TB therapy (rifampicin, isoniazid) prior to surgery.

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Section: Discussionmentioning

confidence: 99%

A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease

Jones

Choong

Canham

et al. 2015

annals

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“…However, this term can be misleading, because Osler was describing the mushroom-like appearance, rather than any of the underlying microbiological features. Actually, mycotic aneurysms are more frequently caused by bacterial infection than by fungal infection [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Pseudoaneurysms can develop immediately after a traumatic event, but more usually show delayed occurrence after days, months, or even longer [7,8]. There are also reports on mycotic (infective) pseudoaneurysms, which tended to focus predominantly on the carotid arteries [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Pseudoaneurysm of the facial artery territory in an odontogenic infection setting

et al. 2015

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A pseudoaneurysm of the facial artery is a rare event. It results from vessel wall disruption with blood tamponade from the surrounding tissues, and is usually caused by blunt facial trauma, with other etiologies rarely reported. We present two cases of a pseudoaneurysm in the facial artery territory in an odontogenic infection setting, highlighting the importance of computed tomography angiography for diagnosis and hastening treatment by vascular embolization.

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“…The application of 18 F-FDG PET to the detection and management of patients with occult infection is evolving and, to date, has been described in a wide range of clinical conditions including osteomyelitis, pyrexia of unknown origin, pericarditis, vascular graft infections and fistulae, diabetic foot infections, painful lower limb prostheses, and mycotic aneurysms [3, [35][36][37][38][39][40][41][42][43].…”

Section: Pet/ct In Infective Endocarditismentioning

confidence: 99%

What Can We Learn About Valvular Heart Disease From PET/CT?

et al. 2013

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Valvular heart disease is a major cause of morbidity and mortality, and with an aging population, its prevalence is increasing. Here, we review the evolving use of positron emission tomography/computed tomography in valvular heart disease, with particular focus on calcific aortic stenosis and infective endocarditis. In principle, the activity of any pathological process can be studied, as long as an appropriate radiotracer can be developed. We will review some of the early data using established tracers in the above and other conditions, providing discussion as to the future research and clinical roles of these techniques. Furthermore, we will discuss the potential impact of novel tracers that are currently under development or testing in preclinical models. It is hoped that such advanced imaging might improve the diagnosis, treatment and outlook for patients with valvular heart disease.

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Mycotic aneurysms: a case report, clinical review and novel imaging strategy

Cited by 58 publications

References 63 publications

A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease

A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease

Pseudoaneurysm of the facial artery territory in an odontogenic infection setting

What Can We Learn About Valvular Heart Disease From PET/CT?

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