Aneurysm, Infected/surgery* ; Endocarditis/surgery* ; Endocarditis, Bacterial/surgery* ; Humans ; Intracranial Aneurysm/surgery*

Flow reversal and thromboexclusion constitute a valuable alternative for aortic surgeons to have within their technical armamentarium for the treatment of aortic aneurysmal disease. Although not usually a preferred treatment for general aortic pathologies, this technique can be considered as a treatment option in select situations, such as mycotic aneurysm, a hostile surgical field, and a poor condition of the patient. Here, we present a case of extra-anatomic bypass and thromboexclusion for recurrent aortic aneurysm after previous extra-anatomic bypass and thromboexclusion surgery.
Aneurysm, Infected ; Aortic Aneurysm ; Humans ; Pathology ; Surgeons

Primary aortic angiosarcoma is very rare, and preoperative diagnosis is challenging with resultant poor prognosis. Angiosarcoma may mimic an infected aneurysm or a mural thrombus. Clinical suspicion of angiosarcoma is vital for an early diagnosis and proper surgical treatment, especially in cases with atypical rapid growth of an aortic abdominal aneurysm with a thrombotic mass. Herein, we report a case of angiosarcoma in the abdominal aorta mimicking an infected aneurysm and present computed tomography and positron emission tomography findings.
Aneurysm ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Diagnosis ; Early Diagnosis ; Hemangiosarcoma ; Positron-Emission Tomography ; Prognosis ; Thrombosis

Introduction: Ruptured mycotic aortic aneurysm is a rare and life-threatening condition. An early and proper initiation of antibiotics aside from aneurysmal repair is of paramount importance. The typhidot IgG and IgM may help with this dilemma, especially when the blood culture is negative and during the waiting period for the the aortic sample result. Case: A 47-year-old male Filipino with type 2 diabetes mellitus presented with severe back pain for one month and intermittent fever for three weeks. Complete blood count showed anemia and leukocytosis with predominance of neutrophils. On computed tomography of the aorta, a segmental calcification and wall discontinuity in the right posterolateral wall of the infrarenal abdominal aorta with heterogenous collection of blood in the retroperitoneal region was seen and aortic rupture secondary to mycotic aneurysm was considered. He underwent emergency abdominal aortic aneurysm repair with debridement, antibiotic lavage, aortoiliac grafting, anastomosis and omental packing. The typhidot IgG and IgM test was positive and was given ceftriaxone 2gm/IV every 24 hours for six weeks. Blood cultures did not reveal significant growth of any pathogen. The aortic wall culture showed heavy growth for salmonella species sensitive to ceftriaxone, confirming and guiding the management. He was then discharged improved. Conclusion A mycotic aneurysm secondary to salmonella should be one of the considerations in an adult male diabetic presenting with prolonged fever, abdominal and back pain with or without a tender pulsatile mass. The Typhidot test is an easy and affordable test that allows rapid detection of salmonella infection. Early surgical intervention and antibiotics are the treatment of choice
Aneurysm, Infected ; Salmonella

Mycotic aneurysms of the common carotid artery (CCA) are very rare and warrant surgical treatment to prevent rupture and death. A 89-year-old man who complained of a sore throat and swelling of the right side of neck. He had no history of trauma or neck infection. Physical examination revealed hard and pulsatile mass. Computed tomography showed initially pseudoaneurysm rupture on the right CCA with surrounding inflammation. The emergency operation revealed mycotic aneurysm rupture with CCA necrosis and was successfully done by wide debridement and carotid artery resection with interposition bypass. The resected tissue and blood culture grew growth of Staphylococcus aureus group. We report a rare case of mycotic aneurysm of right CCA that treated by bypass interposition.
Aged, 80 and over ; Aneurysm, False ; Aneurysm, Infected ; Carotid Arteries ; Carotid Artery, Common ; Debridement ; Emergencies ; Humans ; Inflammation ; Neck ; Necrosis ; Pharyngitis ; Physical Examination ; Rupture ; Staphylococcus aureus

Behçet's disease is a systemic vasculitis of unknown etiology characterized by recurrent oral and genital ulcers and uveitis. The vascular involvement of Behçet's disease affects arteries, veins, and blood vessels of all sizes, and it can include venous or arterial thrombosis and arterial aneurysms. There are only a few reports of an aortic aneurysm invading a vertebral body in a patient with Behçet's disease. Here, we report the case of a 45-year-old man who was initially diagnosed with vertebral invasion of a mycotic aneurysm. He underwent vascular surgery and received empirical antibiotics, but all cultures were negative. However, he had persistent, recurrent deep vein thrombosis and elevated inflammatory markers. After reviewing the pathology, a final diagnosis of Behçet's disease was made. He was successfully treated with corticosteroids. This report presents a rare case of Behçet's disease mimicking vertebral invasion of a mycotic aneurysm.
Adrenal Cortex Hormones ; Aneurysm ; Aneurysm, Infected* ; Anti-Bacterial Agents ; Aortic Aneurysm ; Arteries ; Behcet Syndrome ; Blood Vessels ; Diagnosis ; Humans ; Middle Aged ; Osteomyelitis ; Pathology ; Systemic Vasculitis ; Thrombosis ; Ulcer ; Uveitis ; Veins ; Venous Thrombosis

BACKGROUND: Mycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy. METHODS: From 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue. We recorded the clinical findings, anatomic location of the aneurysm, bacteriology results, antibiotic therapy, morbidity, and mortality for these cases. RESULTS: The median age was 62±7.2 years (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was 44.5±4.9 mm. The mean time from onset of illness to surgery was 14.5±2.4 days. Aortic continuity was restored in situ with a Dacron prosthesis (79%), homograft (16%), or Gore-Tex graft (5%). Soft-tissue coverage of the prosthesis was performed in 8 patients. The mean follow-up time was 43.2±11.7 months. The early mortality rate was 10.5%, and the 5-year survival rate was 74.9%±11.5%. CONCLUSION: This study showed acceptable early and midterm outcomes of open repair of mycotic aneurysms. We emphasize that aggressive intraoperative debridement with soft-tissue coverage results in a high rate of success in these high-risk patients.
Allografts ; Aneurysm ; Aneurysm, Infected ; Aortic Aneurysm* ; Aortic Aneurysm, Abdominal ; Aortic Aneurysm, Thoracic ; Bacteriology ; Debridement ; Follow-Up Studies ; Humans ; Male ; Mortality ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Prostheses and Implants ; Survival Rate ; Transplants

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascularrelated underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.
Aneurysm, False* ; Aneurysm, Infected ; Anti-Bacterial Agents ; Bacteremia ; Child* ; Child, Preschool ; Diagnosis ; Exanthema ; Fever ; Humans ; Iliac Artery ; Leg ; Male ; Pediatrics ; Pharyngitis ; Scarlet Fever ; Streptococcus pyogenes ; Streptococcus* ; Thoracic Surgery

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascularrelated underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.
Aneurysm, False* ; Aneurysm, Infected ; Anti-Bacterial Agents ; Bacteremia ; Child* ; Child, Preschool ; Diagnosis ; Exanthema ; Fever ; Humans ; Iliac Artery ; Leg ; Male ; Pediatrics ; Pharyngitis ; Scarlet Fever ; Streptococcus pyogenes ; Streptococcus* ; Thoracic Surgery

Reported is a case of a 20-year old G2P1 (1001) Pregnancy Uterine 22 weeks age of gestation (AOG), who suffered three episodes of aneurysmal rupture over a period of almost 8 weeks, the last being fatal occurring on the 27th week AOG, despite aggressive antimicrobial treatment, insertion of ventriculo-peritoneal shunt and clinically improving neurologic status. The patient succumbed to subarachnoid hemorrhage resulting from the third aneurysmal rupture. Mycotic aneurysm is a serious and catastrophic clinical condition, more so in a pregnant patient wherein management options are limited in order to preserve pregnancy.

This report will discuss the first documented case in the Philippines of mycotic aneurysm in pregnancy secondary to a valvular heart disease, to increase awareness on such cases for timely diagnosis and management.

Human ; Female ; Pregnancy ; Subarachnoid Hemorrhage ; Aneurysm, Infected ; Anti-infective Agents ; Ventriculoperitoneal Shunt ; Philippines ; Aneurysm, Ruptured ; Anti-bacterial Agents ; Preservation, Biological ; Heart Valve Diseases