Mycotic Pulmonary Aneurysm Managed With Covered Stent

Abstract

Mycotic aneurysms are vascular dilations caused by fungal or bacterial infections. The involvement of the pulmonary artery or its branches is extremely rare with only a few cases reported in the literature posing a diagnostic challenge. We present the case of a young adult patient with acute myeloid leukemia undergoing chemotherapy, who presented with febrile neutropenia, recurrent bacteremia due to Pseudomona Aeruginosa and Klebsiella Pneumonie and hemoptysis. The management was unconventional, opting for the placement of a covered endovascular stent, being the first successful case with this reported technique. Rapid detection of this pathology and individualization in the management of each patient is essential because of high risk of mortality due to sepsis and rupture of the aneurysm.

A Case Report and Review of the Literature: Infectious Aneurysm Formation in the Pulmonary Arteries—A Rare but Perilous Sequela of Persisting Infection With Klebsiella pneumoniae

“…Staphylococci or streptococci were most frequently isolated, but also Gram-negative bacteria and various fungi have been occasionally reported (Jarrett et al, 1975 ; Müller et al, 2001 ; Ebisawa et al, 2018 ). However, no signs of endocarditis were present in our patient, while pulmonary infectious aneurysm have also been repetitively reported independent of present infectious endocarditis (Dransfield and Johnson, 2003 ; Benhassen et al, 2018 ; Alquichire-Luna et al, 2021 ).…”

“…However, the applicability of this study for the case presented remains questionable, as patients were treated either with endovascular or open surgical vascular repair including implantation of foreign body material into pre-infected tissue. Likewise, favorability of either microsurgical resection (current case) or interventional management (Alquichire-Luna et al, 2021 ) of manifested aneurysms in the pulmonary vasculature remains elusive and may rely on the referring center.…”