1/46. Aspergillus osteoarthritis in acute lymphoblastic leukemia.We report an unusual case of arthritis of the right wrist due to aspergillus fumigatus without evidence for a generalized infection, following chemotherapy for acute lymphoblastic leukemia. The diagnosis was made by surgical biopsy. Amphotericin-B (Am-B) was not tolerated by the patient. Liposomal preparations of Am-B penetrate poorly into bone and cartilage. Therefore, oral itraconazole was given; the arthritis improved and chemotherapy was continued without infectious complications. Two weeks after complete hematopoietic recovery, an intracranial hemorrhage from a mycotic aneurysm of a brain vessel occurred, although the patient was still receiving itraconazole. We emphasize the importance of prompt and thorough efforts to identify the causative agent in immunocompromised patients with a joint infection. itraconazole is effective in Aspergillus osteoarthritis but, due to its poor penetration into the brain, the combination with a liposomal formulation of Am-B is recommended.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/46. Mycotic aneurysm of the thoracic aorta due to Aspergillus terreus: case report and review.Mycotic aneurysms of the aorta caused by fungi are uncommon. We describe an unusual case of aortic aneurysm infection caused by Aspergillus terreus, which most likely spread from an adjacent pulmonary focus. Successful treatment included partial pneumonectomy, resection of the aneurysm with graft repair, and prolonged sequential administration of amphotericin b and itraconazole. A review of the published experience with aortic aneurysms caused by Aspergillus species is also presented. When invasive aspergillosis is suspected in proximity to areas with major vascular structures in immunocompromised patients, further investigation to rule out vascular invasion may be warranted. If the diagnosis is confirmed, aggressive and prompt treatment with antifungal agents combined with surgical debridement is essential to improve outcome.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
3/46. Mycotic abdominal aortic aneurysm: a fatal sequel to concomitant prostatic and renal aspergillosis. Case report and review of the literature.We report the first case of aspergillus mycotic aneurysm as a sequel to concomitant prostatic and renal aspergillosis. The patient had undergone left nephrectomy and transurethral resection of prostate for aspergillus infection one year ago. He again presented with LUTS and backache and clinical examination showed visible pulsations in the epigastrium. CT-scan abdomen showed a pseudoaneurysm of the abdominal aorta. The aneurysm was repaired in situ with homografting and omental wrap. However, the patient succumbed to septicemia on the tenth postoperative day. Adjunctive surgery is usually essential as medical management alone has been unsatisfactory. It is imperative that these cases should be followed closely to detect the disease recurrence and complications at the earliest.- - - - - - - - - - ranking = 8.7677226434321keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
4/46. Mycotic pseudoaneurysm of the aortic arch: an unusual complication of invasive pulmonary aspergillosis.invasive pulmonary aspergillosis (IPA) is usually a condition of the immunocompromised patients. The organism has a tendency to invade pulmonary blood vessels. Extension of a pulmonary parenchymal lesion to involve the mediastinal great vessels is very rare. This is the first case where the extension of IPA to the aortic arch and the formation of a pseudoaneurysm were demonstrated on serial CT scans.- - - - - - - - - - ranking = 13.838613217161keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/46. Mycotic aneurysm and cerebral infarction resulting from fungal sinusitis: imaging and pathologic correlation.SUMMARY: A 73-year-old man was admitted with invasive aspergillus of the sphenoid sinus. Endoscopic debridement of the sphenoid sinus was complicated by rupture of a mycotic cavernous carotid artery aneurysm with severe epistaxis. The aneurysm was closed emergently by endovascular coil placement. Subsequently, the mycotic aneurysm extended intradurally and caused fatal subarachnoid hemorrhage. The radiologic-pathologic data illustrate the mechanism of fungal mycotic aneurysm formation and growth. This case emphasizes the need for rapid diagnosis of potential fungal involvement of the central nervous system and suggests the necessity for aggressive treatment once fungal cerebrovascular involvement is identified.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
6/46. Case report. Mycotic arteritis due to aspergillus fumigatus in a diabetic with retrobulbar aspergillosis and mycotic meningitis.A 74-year-old man with diabetes mellitus type II, retinopathy and polyneuropathy suffered from exophthalmus, ptosis and diplopia. magnetic resonance imaging and computer tomography showed a space-occupying process in the right orbital apex. An extranasal ethmoidectomy accompanied by an orbitotomia revealed the presence of septated hyphae. aspergillus fumigatus was grown from the tissue. After surgical removal of the fungal masses, therapy with amphotericin b (1 mg kg(-1) body weight) plus itraconazole (Sempera, 200 mg per day) over 6 weeks was initiated. Five months later the patient's condition deteriorated again, with vomiting, nausea and pain behind the right eye plus increasing exophthalmus. Antifungal therapy was started again with amphotericin b and 5-fluorocytosine. neutropenia did not occur. The patient became somnolent and deteriorated, a meningitis was suggested. Aspergillus antigen (titre 1:2, Pastorex) was detected in liquor. Anti-Aspergillus antibodies were not detectable. Both the right eye and retrobulbar fungal masses were eradicated by means of an exenteratio bulbi et orbitae. However, renal insufficiency and an apallic syndrome developed and the patient died. At autopsy, a mycotic aneurysm of the arteria carotis interna dextra was detected. The mycotic vasculitis of this aneurysm had caused a rupture of the blood vessel followed by a massive subarachnoidal haemorrhage. In addition, severe mycotic sphenoidal sinusitis and aspergillosis of the right orbit were seen, which had led to a bifrontal meningitis.- - - - - - - - - - ranking = 2keywords = aneurysm (Clic here for more details about this article) |
7/46. Pseudoaneurysm of the iliac artery secondary to Aspergillus infection in two recipients of kidney transplants from the same donor.The authors report 2 cases of patients who underwent cadaveric renal transplantation from the same donor in a multiorgan extraction procedure. Both cases showed, during the first 6 months posttransplantation, a worsening in renal graft function and signs of ischemia in the homolateral lower limb. One of the cases was preceded by pain in the sciatic region. In imaging tests, a pseudoaneurysm was detected in the iliac artery in both patients. Grafts had to be removed, and the iliac arteries were ligated with posterior isolation of Aspergillus spp from the arterial vessels but not from the renal tissue. Besides surgery, medical treatment with liposomal amphotericin b was initiated with a different outcome in each patient: patient A died, whereas patient B recovered. The absence of Aspergillus spp infection in liver and heart recipients ruled out a donor-transmitted infection. The graft placements were carried out in different operating rooms, which rules out contamination during the transplantation process. All of this leads us to conclude that the infection must have occurred during the preservation phase of the kidney.- - - - - - - - - - ranking = 6.7677226434321keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
8/46. Intracranial mycotic aneurysm caused by Aspergillus--case report.A 75-year-old female with chronic renal failure diagnosed as Wegener's granulomatosis was receiving steroids and immunosuppressive agents when subarachnoid hemorrhage developed. cerebral angiography showed a fusiform aneurysm arising from an angular branch of the left middle cerebral artery. Hemorrhage occurred and the aneurysm was excised by emergency surgery. Microscopic examination of the aneurysm revealed dense infiltration of hyphae identified as Aspergillus. She died of subsequent hemorrhage. autopsy showed numerous Aspergillus hyphae in the lung. Fungal mycotic aneurysm should be considered in the differential diagnosis of an immunocompromised patient with subarachnoid hemorrhage.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
9/46. Tumoral form of aspergillosis in central nervous system (cerebral aspergilloma): case report.Aspergillosis of the central nervous system is an uncommon infection, mainly occurring in immunocompromised patients. It may be presented in several forms: meningitis, mycotic aneurysms, infarcts and the tumoral form (aspergilloma). The authors report a case of a diabetic patient with cerebral aspergilloma.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
10/46. Aspergillotic aneurysm formation of cerebral artery following neurosurgical operation.A rare case of intracranial aspergillotic aneurysm following neurosurgical operation for facial spasm is presented. Severe meningitis had persisted several days prior to the subarachnoid hemorrhage which occurred on 70th postoperative day. Angiography demonstrated a fusiform aneurysm at the peduncular segment of the superior cerebellar artery on the other side of operation. As the repeated cultures of CSF were negative, the pathogenetic factor causing aneurysm formation could not be identified before second operation of aneurysmal resection. Pathological study of the specimen revealed the arterial wall being deeply invaded by aspergillotic hyphae.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
| | Next -> |