Mycotic Embolism and Embolomycotic Aneurysms

Abstract

During the past decade, nine patients with bacterial endocarditis have required management of mycotic emboli and/or aneurysms in this center. In these patients, 25 separate mycotic emboli or aneurysms were identified. Among these were four visceral, 11 lower extremity, one aortic, one hypogastric, and eight cerebral lesions. Multiple sites were involved in seven of the nine patients (78%). Presenting symptoms were secondary to acute expansion of mycotic aneurysms in three patients and secondary to rupture of aneurysms in four patients. Mycotic emboli produced cerebral infarction in two patients and acute ischemia in six patients. Asymptomatic mycotic aneurysms of the middle cerebral, hepatic, hypogastric, and profunda femoris arteries and asymptomatic emboli to the profunda femoris and tibial arteries were found during angiographic study. Management included resection alone (7 aneurysms), resection and graft replacement (2 aneurysms and 2 emboli), embolectomy (2), or observation. There was no mortality or loss of limb in these patients. This experience underscores the frequent multiplicity of mycotic emboli and/or aneurysms and stresses the importance of empiric angiographic survey to exclude silent yet potentially lethal visceral and cerebral mycotic foci in patients with bacterial endocarditis and peripheral emboli or aneurysms.

Popliteal artery pseudoaneurysm: A rare complication of brucellosis

“…2,3 In adults, endocarditis affects the aortic valves in 75% of cases and may involve native or prosthetic valves with or without annular destruction. 5 Development of mycotic aneurysms has been reported to be a complication of subacute bacterial endocarditis, 5,6 but such endocarditis was not confirmed in our patient's case. In these aneurysms, several pathogenic mechanisms are involved, and they may operate at the same time.…”

Large mycotic aneurysm of the peroneal artery

“…The vast majority of reported cases of MAs involve major axial vessels proximal to the popliteal artery. 5 However, rare cases of MA involving the posterior tibial artery, anterior tibial artery, tibioperoneal trunk, and the dorsalis pedis artery have been reported 1,3,[5][6][7][8][9][10][11] (Table 1). Most MAs require surgical treatment.…”

Cause of internal hemorrhage determined after exhumation: Report of one case

“…The literature suggests that infected aneurysms tend to be within the distal arterial bed and hence are peripherally located or lie within the parenchyma of the involved organ [17,18]. Infected aneurysms are uncommon but can affect any artery [12,19,20]. Staphylococcus and Streptococcus species are the most common causes of infected aneurysms [21][22][23][24].…”