Popliteal artery pseudoaneurysm: A rare complication of brucellosis

Abstract

Brucellosis is still a public health problem, particularly in developing countries. After the primary infection subsides, a chronic stage characterized by nonspecific manifestations can develop, during which it may not be possible to isolate Brucella organisms and agglutination test titers may or may not be high. We present the case of a 49-year-old man who had only nonspecific symptoms and a 2-month history of a pulsatile painful swelling in his right popliteal region. He had no history of trauma or surgery in that region, but he did ingest unpasteurized milk products. The patient's agglutination test titers were high, and Brucella melitensis was isolated from a bone marrow culture. Color Doppler sonography, T2-weighted MRI, and digital subtraction angiography were performed. Treatment with ultrasound-guided compression of the pseudoaneurysm failed because of high blood flow in its neck. Aneurysmectomy was undertaken, and the excised material was consistent with that from a mycotic pseudoaneurysm. Although both MRI and angiography provided useful information, the color Doppler sonography findings were characteristic of a pseudoaneurysm in the popliteal artery, and only that modality could detect the flow dynamics within the pseudoaneurysm.

Infected abdominal aortic aneurysm caused by Brucella abortus: A case report

“…Most reported infected aneurysms caused by the Brucella spp have been peripheral arterial aneurysms, which were secondary complications of infective endocarditis. [3][4][5][6][7] Our patient had a primary infected abdominal aortic aneurysm without any evidence of preceding infective endocarditis; the infection was caused by B abortus. To our knowledge, this is the first time that an infected abdominal aortic aneurysm caused by B abortus has been reported in the worldwide medical literature as well as the first case of an infected aneurysm caused by the Brucella spp to be reported in Korea.…”

Case Report: A Pseudoaneurysm Involving the Left Common Iliac Artery Secondary to Brucellosis: A Rare Case Report

“…The incidence of positive blood cultures (particularly following antibiotic therapy) is clinically insignificant, and markers such as erythrocyte sedimentation rate, C-reactive protein ( al-Kassab et al, 1991 ), and procalcitonin are not specific for infected pseudoaneurysms ( Kayaaslan et al, 2016 ; Liu and Zhao, 2017 ). The signs and symptoms of the patient were not specific ( Harman et al, 2004 ). Patients in some cases were asymptomatic.…”

Endovascular treatment of thoracic aortic pseudoaneurysm due to brucellosis: a rare case report

“…Although rare, such vascular complications are so deadly they are the primary cause of death related to brucellosis. Pseudoaneurysm secondary to brucellosis is extremely rare in the peripheral arteries, but it is a very severe and dangerous complication [5–7]. In other case studies, it has been reported that mycotic pseudoaneurysm usually is due to trauma to the arterial wall with subsequent contamination [6, 16–21].…”

“…More than 75% of deaths related to brucellosis occurred due to endocarditis [3, 4]. Pseudoaneurysms in peripheral arteries have been reported in a few cases, [5–7] but there has been no report of the occurrence of a thoracic aortic pseudoaneurysm secondary to brucellosis. Here, we describe a rare case of a brucellosis-induced thoracic aortic pseudoaneurysm and discuss the treatment procedure applied for this patient.…”