Mycotic aneurysms following purulent meningitis

Hannesson, B.; Sachs, Ernest

doi:10.1007/bf01405414

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1974

1990

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Cited by 20 publications

(1 citation statement)

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“…A 25-year-old right-handed woman was admitted to Philadelphia General Hospital (PGH) on Nov 10,1971, with the sudden on¬ set of left-sided weakness. At 11 years of age, she had rheumatic fever with the sub¬ sequent development of an asymptomatic heart murmur.…”

Section: Patient Summarymentioning

confidence: 99%

Mycotic Aneurysm

Katz¹

1974

Arch Intern Med

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Section: Patient Summarymentioning

confidence: 99%

Mycotic Aneurysm

Katz¹

1974

Arch Intern Med

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Mycotic aneurysm. Case report with novel sequential angiographic findings

Katz¹

1974

Archives of Internal Medicine

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The diagnosis and treatment of cerebral mycotic aneurysms

Brust

Dickinson

Hughes

et al. 1990

Annals of Neurology

127

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Seventeen patients were treated for 28 documented cerebral mycotic aneurysms. Initial neurological symptoms were attributable to aneurysm rupture in only 7 patients, and in 3 of them symptoms did not suggest subarachnoid hemorrhage. Six patients presented with embolic infarction and 1 with meningitis; in 3 patients it was uncertain if aneurysm rupture occurred. Four patients had rupture of at least one aneurysm while receiving appropriate antibiotic treatment and another had rupture at the conclusion of therapy. Of 20 aneurysms followed angiographically or with computed tomography during medical treatment, 10 became smaller or disappeared and 10 remained unchanged or enlarged, 1 with fatal rupture. Eight ruptured aneurysms were surgically excised; 2 of the patients with ruptured aneurysms died and 2 had residual aphasia or cognitive impairment. All 4 patients whose only surgery was for an unruptured aneurysm made uneventful recoveries. Recognizing the retrospective and anecdotal nature of our data and the differing views of previous investigators, we recommend: (1) that careful neurological examination, computed tomography, and (unless contraindicated) lumbar puncture be performed on any patient with endocarditis; (2) that those with neurological abnormalities not attributable to systemic toxicity, including pleocytosis in the cerebrospinal fluid or apparent infarction on computed tomographic scans, undergo four-vessel cerebral angiography; (3) that single accessible mycotic aneurysms in medically stable patients be promptly excised, with individualization of multiple or proximal aneurysms; and (4) that repeat angiography be performed at the conclusion of antibiotic therapy in patients requiring long-term anticoagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

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Mycotic aneurysms following purulent meningitis

Cited by 20 publications

References 14 publications

Mycotic Aneurysm

Mycotic Aneurysm

Mycotic aneurysm. Case report with novel sequential angiographic findings

The diagnosis and treatment of cerebral mycotic aneurysms

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