Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
Actinomycosis/*complications ; Aged ; Aneurysm, Infected/*etiology/*radiography/therapy ; Embolization, Therapeutic ; Human ; Male ; Pneumonia, Bacterial/*complications ; *Pulmonary Artery ; Treatment Outcome

We report herein a case successful endovascular treatment with a stent-graft of a rare case of rapidly growing mycotic aneurysm of the left common carotid artery due to acute bacterial endocarditis after eradication of the infection. Infected mycotic aneurysms of the peripheral vasculature have been considered as a contraindication for stent-graft implantation because of the possibility of microorganism spreading to the stent-graft; however, if there is evidence of complete eradication of microorganism and surgery is not an option, stent-graft implantation can be an effective and safe treatment modality for exclusion of the mycotic aneurysm.
Acute Disease ; Aged, 80 and over ; Aneurysm, Infected/etiology/radiography/*therapy ; Angioplasty/*methods ; Carotid Artery Diseases/etiology/radiography/*therapy ; Endocarditis, Bacterial/*complications/radiography ; Female ; Humans ; *Stents ; Treatment Outcome

A 62-year-old woman has been suffered from cavernous sinus thrombophlebitis which was confirmed by four-vessel angiography, orbit magnetic resonance imaging, and blood culture. Three weeks after recovery of cavernous sinus thrombophlebitis, right eye proptosis and complete third, fourth, and sixth cranial nerve palsies developed. Best-corrected visual acuity decreased to 20/70 in the right eye. Repeat magnetic resonance imaging demonstrated a 1.5-cm-sized mass in the right cavernous sinus, suspicious for mycotic aneurysm. Amphotericin B supplementation was begun and was followed by successful transarterial Guglielmi detachable coil embolization. Four months later, extraocular movement was normalized, and visual acuity improved to 20/25 in the right eye.
Amphotericin B/therapeutic use ; Aneurysm, Infected/*etiology/*therapy ; Angiography ; Antifungal Agents/therapeutic use ; Cavernous Sinus Thrombosis/*complications ; Embolization, Therapeutic/*methods ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Visual Acuity