1/16. Endovascular repair of an inflammatory abdominal aortic aneurysm complicated by aortoduodenal fistulation with an unusual presentation.Aortoenteric fistulation (AEF) is a well-documented late complication of open abdominal aortic aneurysm (AAA) repair, occurring in between 0.4% and 4% of cases. In the absence of an anastomosis, AEF is likely to be rare after endovascular aneurysm repair (EVAR) and has only recently been described in the literature as a result of mechanical stent failure or migration. We present the case of a 61-year-old man who underwent EVAR for an AAA with a "nonspecific" periaortic inflammatory mass. Six months postoperatively, an AEF developed, presenting with metastatic sepsis followed by septic infective thromboembolization to his right leg, and amputation was necessary. His stent was well positioned and mechanically intact. We emphasize the need for vigilance about the risk of AEF when adopting an endovascular approach to repair the AAA with a nonspecific periaortic inflammatory mass and highlight the need for awareness about the unusual septic manifestations of AEF.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/16. Successful treatment of vancomycin-resistant enterococcus faecium meningitis with linezolid: case report and literature review.vancomycin-resistant enterococci (VRE) are a rare cause of meningitis, occurring primarily in patients who have undergone neurosurgical procedures. We describe the first reported case of VRE meningitis successfully treated with linezolid. A 56-y-old female with subarachnoid hemorrhage underwent ventriculostomy and embolization of cerebral aneurysms. Her postoperative course was complicated by multiple infections needing repeated antibiotic courses, culminating in the development of VRE meningitis. She was treated with 600 mg of i.v. linezolid (MIC < 0.75 microg/ml) every 12 h for 6 weeks. After the fourth dose, peak and trough linezolid concentrations were 11.45 and 0.14 microg/ml in serum and 3.19 and 2.39 microg/ml in cerebral spinal fluid (CSF). On Day 19 of linezolid therapy, serum and CSF trough concentrations were 1.53 and 2.98 microg/ml, respectively. Linezolid achieved sufficient CSF concentrations to bring about clinical and bacteriological cure. We conclude that i.v. linezolid may be a useful option for treating VRE meningitis. We also present findings of a literature review, which identified 11 cases of VRE meningitis treated with other pharmacologic agents with mixed success.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
3/16. Nontraumatic hepatic artery pseudoaneurysm associated with acute leukemia: a possible complication of pyogenic liver abscess.Most hepatic artery pseudoaneurysms result from trauma, blunt or penetrating, such as that caused by percutaneous transhepatic procedures. We present a case of hepatic artery pseudoaneurysm resulting from a pyogenic liver abscess, which has not been described previously, in a patient with acute leukemia receiving chemotherapy.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
4/16. Cerebral mycotic aneurysm complicating Stomatococcus mucilaginosus infective endocarditis.Stomatococcus mucilaginosus is a gram-positive coccus present in the normal flora of the mouth and upper respiratory tract of humans. Although traditionally believed to be an organism of low virulence, S. mucilaginosus has recently been recognized as an emerging opportunistic pathogen, especially in patients with chronic immunosuppressive diseases. This report describes the case of a patient with known mitral valve prolapse, who presented with a mycotic cerebral aneurysm revealing a non-nosocomial spontaneous S. mucilaginosus endocarditis. The spectrum of infections due to this opportunistic pathogen is reviewed, with particular focus on assessing the clinical characteristics and prognosis of S. mucilaginosus infective endocarditis.- - - - - - - - - - ranking = 4.0174977197306keywords = mycotic aneurysm, aneurysm (Clic here for more details about this article) |
5/16. Cervical epidural abscess secondary to aorto-duodenal fistula: a case report.Although cervical epidural abscess is rare, it should be strongly suspected in any patient with unexplainable neck pain and fever, especially when the patient has a predisposing factor for this infectious process. The authors report a case of cervical epidural abscess in a 39-yr-old man with an aorto-duodenal fistula, which complicated the interposition of artificial graft for abdominal aortic aneurysm rupture, which had undertaken 40 months before. Timely detection and intervention rendered him a full neurological recovery. This extremely rare case is presented with a literature review.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
6/16. Endoluminal repair of mycotic thoracic aneurysms.PURPOSE: To report a series of endoluminally repaired mycotic thoracic aneurysms. case reports: Four patients with presumed mycotic aneurysms of the thoracic aorta were treated with endovascular grafts owing to overly high risk for open repair. All aneurysms were successfully excluded at the initial intervention. In one case, which required endograft fenestrations for the superior mesenteric and renal arteries, the patient died 53 days after the procedure, following graft migration and occlusion of major branch vessels. The other 3 patients remain alive and well at a mean follow-up of 16 months with no signs of ongoing sepsis. CONCLUSIONS: Endoluminal repair of thoracic mycotic aneurysms is technically feasible and, in association with long-term antibiotics, offers at least temporary protection against imminent rupture.- - - - - - - - - - ranking = 2.925415526532keywords = mycotic aneurysm, aneurysm (Clic here for more details about this article) |
7/16. A case of graft infection 10 years after ascending aorta replacement.A 52-year-old man was admitted with anemia and slight fever, which he had for the last 2 months. He had undergone replacement of the ascending aorta for acute aortic dissection 10 years previously. echocardiography demonstrated a flailing thin structure in the anterior wall of the ascending aorta corresponding to the proximal portion of the prosthetic graft. This abnormal echocardiographic finding led us to repeat blood cultivation. We finally detected Enterococcus facium and staphylococcus epidermidis in his blood sample. We diagnosed this as a graft infection and prepared for surgical re-replacement of the infected graft. While he was waiting for the operation, an infectious aneurysm of a tibialis posterior artery ruptured and an emergency operation was done. Replacement of the infected ascending aorta graft was done thereafter. In surgery, 2-cm-long vegetation was found. It stuck to the graft wall near the former hole used for air removal in the first surgery. The patient recovered fully and left our hospital after 3 months of postoperative antibiotics therapy. This rare case of aortic graft infection long after the original replacement surgery suggests the importance of thorough echocardiographic investigation of prosthetic graft infection as a possible cause of fever of unknown origin.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
8/16. propionibacterium acnes prosthetic valve endocarditis: a case of severe aortic insufficiency.propionibacterium acnes rarely causes systemic disease. Few cases of P. acnes endocarditis have been reported. This report describes a 63-year-old man who presented with severe congestive heart failure. He had prosthetic valve endocarditis which resulted in severe acute aortic insufficiency. During surgery he was found to have complete disruption of the aorta and left ventricle with a false aneurysm encompassing the circumference of the aortic annulus. Cultures of the valve grew P. acnes. Thus, although P. acnes is a rare cause of endocarditis, it may pursue a very aggressive course, especially in the setting of a prosthetic valve.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
9/16. Surgical management of mycotic aneurysm of the left anterior descending artery.Mycotic aneurysms of the coronary artery with underlying infective endocarditis are rare. The present report discusses the case of a 53-year-old woman with acute ST elevation myocardial infarction in the setting of native aortic valve endocarditis. Percutaneous transluminal coronary angioplasty was performed. Approximately four weeks after hospital admission, the patient had systemic embolization to the extremities with resulting cyanosis of the left toes. She was evaluated for replacement of the aortic valve and underwent a repeat angiogram, which demonstrated a mycotic aneurysm at the site of the angioplasty. She subsequently underwent successful excision of the aneurysm with coronary artery bypass grafting and replacement of the aortic valve with a 21 mm St Jude aortic valve prosthesis. The remaining hospital course was unremarkable.- - - - - - - - - - ranking = 5.1468721496633keywords = mycotic aneurysm, aneurysm (Clic here for more details about this article) |
10/16. Stereotactic, angiography-guided clipping of a distal, mycotic intracranial aneurysm using the Cosman-Roberts-Wells system: technical note.We describe the use of stereotactic, angiographic guidance for localization and clipping of a small, distal intracranial bacterial aneurysm. The technique uses the commercially available Suetens-Gybels-Vandermeulen angiographic localizer with the widely used Cosman-Roberts-Wells stereotactic system. This method is simple and easy to use and significantly decreased the operative time. It may be quite useful for surgically treating mycotic and other peripheral aneurysms.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
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