Mycotic aneurysm: Difference between revisions
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==Background== | ==Background== | ||
[[File:Mycotic pulmonary artery aneurysm, ruptured (4860663580).jpg|thumb|A mycotic aneurysm of the pulmonary artery complicating tricuspid infectious endocarditis. The aneurysm has ruptured producing massive hemorrhage.]] | |||
*Arterial vessel wall dilation due to bacterial, fungal, or viral infection <ref>Majeed H, Ahmad F. Mycotic Aneurysm. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560736/</ref> | *Arterial vessel wall dilation due to bacterial, fungal, or viral infection <ref>Majeed H, Ahmad F. Mycotic Aneurysm. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560736/</ref> | ||
*Incidence is rare | *Incidence is rare | ||
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===Risk Factors=== | ===Risk Factors=== | ||
* Immunocompromised | * Immunocompromised | ||
* IV drug use | * [[IV drug use]] | ||
* Infective endocarditis | * Infective [[endocarditis]] | ||
* | * Status post invasive intravascular procedures | ||
==Clinical Features== | ==Clinical Features== | ||
===Signs/Symptoms=== | ===Signs/Symptoms=== | ||
*Fever | *[[Fever]] | ||
*Pulsatile mass | *Pulsatile mass | ||
*Localized inflammation at arterial access site (if s/p intravascular intervention) | *Localized inflammation at arterial access site (if s/p intravascular intervention) | ||
*Symptoms may vary by location affected (e.g. stroke-like symptoms with intracranial aneurysm, abdominal pain with mycotic AAA) | *Symptoms may vary by location affected (e.g. [[stroke]]-like symptoms with intracranial aneurysm, [[abdominal pain]] with mycotic [[AAA]]) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
==Evaluation== | ==Evaluation== | ||
[[File:Aneurisma micótico de la arteria ilíaca izquierda.jpg|thumb|Mycotic aneurysm of the left iliac artery seen on angiography.]] | |||
===Labs=== | ===Labs=== | ||
*CBC | *CBC | ||
*ESR/CRP | *ESR/CRP | ||
*CMP | *CMP | ||
*Urinalysis | *[[Urinalysis]] | ||
*Blood cultures | *[[Blood cultures]] | ||
*Coagulation studies | *Coagulation studies | ||
*Type and Cross | *Type and Cross | ||
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==See Also== | ==See Also== | ||
*[[Abdominal | *[[Abdominal aortic aneurysm]] | ||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Cardiology]] | |||
[[Category:ID]] | |||
Latest revision as of 18:38, 29 January 2025
Background
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- Arterial vessel wall dilation due to bacterial, fungal, or viral infection [1]
- Incidence is rare
Risk Factors
- Immunocompromised
- IV drug use
- Infective endocarditis
- Status post invasive intravascular procedures
Clinical Features
Signs/Symptoms
- Fever
- Pulsatile mass
- Localized inflammation at arterial access site (if s/p intravascular intervention)
- Symptoms may vary by location affected (e.g. stroke-like symptoms with intracranial aneurysm, abdominal pain with mycotic AAA)
Differential Diagnosis
Evaluation
Labs
- CBC
- ESR/CRP
- CMP
- Urinalysis
- Blood cultures
- Coagulation studies
- Type and Cross
Imaging
- CT angiography (Sensitivity 0.82 (95% CI, 0.77–0.87), specificity 0.93 (95% CI, 0.89–0.95)) [7]
- MR angiography (Sensitivity 0.79 (95% CI, 0.61–0.91), specificity 0.89 (95% CI, 0.81–0.95)) [8]
Management
- Emergent vascular surgery consultation
- Broad spectrum IV antibiotics with gram positive, gram negative, and anaerobic coverage
- Bilateral large-bore peripheral IVs
- Definitive care with surgical debridement and endovascular vs open repair
Disposition
- Admission to OR or ICU in consultation with vascular surgery
See Also
External Links
References
- ↑ Majeed H, Ahmad F. Mycotic Aneurysm. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560736/
- ↑ Parkhurst GF, Dekcer JP. Bacterial aortitis and mycotic aneurysm of the aorta: a report of twelve cases. Am J Pathol 1955; 31:821–835
- ↑ Sommerville RL, Allen EV, Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: a clinicopathologic study. Medicine (Baltimore) 1959; 38:207–221
- ↑ Kannoth S, Thomas SV. Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management. Neurocrit Care 2009; 11:120–129
- ↑ Nakahara I, Taha MM, Higashi T, et al. Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol 2006; 66:405–409; discussion, 409–410
- ↑ González I, Sarriá C, López J, et al. Symptomatic peripheral mycotic aneurysms due to infective endocarditis: a contemporary profile. Medicine (Baltimore) 2014; 93:42–52
- ↑ Wang TKM, Griffin B, Cremer P, et al. Diagnostic Utility of CT and MRI for Mycotic Aneurysms: A Meta-Analysis. AJR Am J Roentgenol. 2020;215(5):1257-1266. doi:10.2214/AJR.19.22722
- ↑ Wang TKM, Griffin B, Cremer P, et al. Diagnostic Utility of CT and MRI for Mycotic Aneurysms: A Meta-Analysis. AJR Am J Roentgenol. 2020;215(5):1257-1266. doi:10.2214/AJR.19.22722