1/8. Mycotic pseudoaneurysm of the aorta in children.Mycotic pseudoaneurysm of the aorta is a rare disease in childhood. We report on two cases which were diagnosed in an unselected general pediatric population within an 8-month period. The first case was a 16-month-old toddler with a normal cardiac history who presented with purulent pericarditis due to group A streptococcus and subsequent pseudoaneurysm formation of the ascending aorta while convalescing from varicella infection. The second case was a 14-year-old girl with a previously undiagnosed coarctation of the aorta who developed a staphylococcus aureus aortitis in the dilated poststenotic segment with pseudoaneurysm formation and infiltration into the adjacent lung tissue. In both cases parenteral antibiotic therapy was administered over 10 and 4 days, respectively, followed by emergency surgery consisting of aneurysmectomy, coarctectomy (case 2), and in situ homograft implantation. Recovery was uneventful. In both cases early institution of a femorofemoral cardiopulmonary bypass prevented a fatal outcome despite intraoperative rupture of the pseudoaneurysm.- - - - - - - - - - ranking = 1keywords = streptococcus (Clic here for more details about this article) |
2/8. streptococcus pneumoniae mycotic aortic aneurysm after allogeneic bone marrow transplantation.BACKGROUND: streptococcus pneumoniae (SP) is a common cause of community-acquired pneumonia and accounts for up to 30% of all cases of pneumonia. patients with chronic graft-versus-host-disease (GvHD) after allogeneic bone marrow transplantation (BMT) have a high susceptibility to SP infections. So far, mycotic aneurysm resulting from SP has not been reported after BMT. methods: We report on a patient with extensive, chronic GvHD who developed low back pain 22 months after allogeneic BMT. RESULTS: Computed tomography of the abdomen displayed mycotic, saccular aneurysmatic enlargement of the infrarenal aorta, with leakage of contrast medium into the aneurysm. The aneurysm was resected, and the defect was closed with an autologous patch from the internal iliac artery. Bacteriologic samples from the abscess grew SP. The patient recovered uneventfully. CONCLUSIONS: This observation confirms the importance of pneumococcal prophylaxis after BMT and suggests that an aggressive diagnostic approach should always be considered in patients with chronic GvHD, even if they present with nonspecific symptoms.- - - - - - - - - - ranking = 3.9257158818513keywords = pneumoniae (Clic here for more details about this article) |
3/8. Multiple mycotic aortic aneurysms due to streptococcus pneumoniae.Primary pneumococcal aortic mycotic aneurysms are rare clinical entities. Only a few cases have been reported in the literature. Extremely rare presentation is the occurrence of three simultaneous aneurysms. Treatment usually necessitates intravenous antibiotherapy combined with staged surgical interventions. This report highlights the case of a 52-year-old man with multiple streptococcus pneumoniae mycotic aneurysms that were simultaneously and successfully treated during a one-stage surgical procedure. The aorta may be prone to infection, especially when its intima is structurally altered by pathologic processes like atherosclerosis, inflammation or trauma. Mycotic aneurysm is a rare but serious vascular condition needing urgent medical and surgical attention because of potential lethal complications.- - - - - - - - - - ranking = 3.9257158818513keywords = pneumoniae (Clic here for more details about this article) |
4/8. Evolving infectious aortitis caused by streptococcus pneumoniae.Infections of major vessels leading to mycotic aneurysms can be a diagnostic dilemma for clinicians, and can be accompanied by a high mortality rate. Successful treatment of this condition often requires a high index of suspicion and prompt medical and surgical attention. The authors report two cases of infectious aortitis caused by pneumococcus that evolved during hospitalization, and discuss diagnostic difficulties that accompany this entity.- - - - - - - - - - ranking = 3.140572705481keywords = pneumoniae (Clic here for more details about this article) |
5/8. Infected aortic aneurysms. A changing entity.Infected (mycotic) aortic aneurysms are infrequent and, without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. Symptoms are frequently absent or non-specific during the early stages, and a high index of suspicion is essential to make the diagnosis. Surgery performed after rupture carries high morbidity and mortality rates. Bacterial endocarditis with streptococcus pyogenes was the most common cause of infected aortic aneurysm in the pre-antibiotic era. Today, arterial trauma due to iatrogenic manipulation and depressed immunocompetence have become more common risk factors. staphylococcus aureus and salmonella are the most frequent bacteria identified. The authors' recent experience in six patients with infected aortic aneurysms who underwent arteriography and computed tomography was reviewed and these diagnostic methods compared. Computed tomography was found to be more sensitive in the diagnosis of the early stages of the disease, allowing for follow-up by serial scans in a noninvasive and less costly manner. Successful treatment, in four of these patients, was accomplished by aneurysmal resection and extra-anatomic bypass or in situ prosthetic reconstruction. A higher clinical awareness of this disease, leading to early computed tomography evaluation and prompt surgical intervention under appropriate and intensive antibiotic therapy, appears to offer the best chance of survival in patients with this difficult condition.- - - - - - - - - - ranking = 1keywords = streptococcus (Clic here for more details about this article) |
6/8. Mycotic aneurysm of the suprarenal aorta secondary to streptococcus pneumoniae: an unusual pathogen.Mycotic aneurysms of the suprarenal aorta are rare lesions, accounting for less than 1% of aortic reconstructions for aneurysmal disease. The bacteriology of these lesions differs from the infrarenal aneurysms and primarily consists of Gram-negative organisms. We report an unusual case of an 87-year-old man successfully treated for a ruptured mycotic suprarenal aortic aneurysm caused by streptococcus pneumoniae. We have not seen a previously reported case where this pathogen has been associated with a suprarenal mycotic aneurysm. The unique bacteriology of these aneurysms is reviewed along with theories of etiology and their classification. The current management of these aneurysms is summarized.- - - - - - - - - - ranking = 3.9257158818513keywords = pneumoniae (Clic here for more details about this article) |
7/8. Mycotic aneurysm of the aorta due to group B streptococcus (streptococcus agalactiae).This report describes the successful treatment by excision and primary anatomic graft of a mycotic aortic aneurysm infected with a Group B Streptococcus.- - - - - - - - - - ranking = 4keywords = streptococcus (Clic here for more details about this article) |
8/8. A case of infectious pseudoaneurysm of the abdominal aorta associated with infectious spondylitis due to klebsiella pneumoniae.A 67-year-old woman with pneumonia and diabetes mellitus was admitted with the complaints of abdominal and back pain. sputum culture was positive for klebsiella pneumoniae. Computed tomographic scanning (CT) of the abdomen and spinal radiograph of the lumber column revealed a paraventebral space-occupying lesion, abdominal aortic aneurysm and destructive change of L3 and L4. Pseudoaneurysm of the abdominal aorta associated with infectious spondylitis with paravertebral abscess was suspected and confirmed by aortography. klebsiella pneumoniae was cultured from the abscess. The patient's condition improved rapidly after drainage of the abscess and administration of LMOX and gentamicin. Infectious pseudoaneurysm of the abdominal aorta associated with infectious spondylitis has rarely been reported. These two in combination due to klebsiella pneumoniae has not been reported to our knowledge. The pathologic changes were found easily by CT scan. When infectious aneurysm or infectious spondylitis is diagnosed alone, possible combination of these diseases should be kept in mind.- - - - - - - - - - ranking = 5.4960022345918keywords = pneumoniae (Clic here for more details about this article) |