How does infective endocarditis cause mycotic aneurysm?
Mycotic aneurysms develop in IE when friable cardiac vegetations give rise to septic emboli that lodge in intracranial vessels at branching points and distal branches. These emboli may occlude vessels, cause cerebral infarction, or promote infection [3].
What is a mycotic aortic aneurysm?
A mycotic aortic aneurysm (MAA), synonymously known as infected aortic aneurysm, is an aortic aneurysm due to infection. Mycotic aortic aneurysm most commonly develops through microbial inoculation of the diseased aortic endothelium during bacteremia.
Is mycotic aneurysm a complication of infective endocarditis?
Mycotic cerebral aneurysm is a rare and potentially fatal complication of infective endocarditis. A young man was diagnosed with culture negative infective endocarditis of mitral valve with cerebral aneurysm.
What bacteria causes mycotic aneurysm?
Staphylococcus and Salmonella spp. are the two most commonly cultured organisms in mycotic aneurysms. However, improved bacteriologic techniques have led to the detection of anaerobic bacteria (mostly Bacteroides, and Clostridium spp.)
How is a mycotic aneurysm treated?
Treatment consists of antibiotic therapy combined with aggressive surgical debridement of the infected tissue and vascular reconstruction, as needed. Endovascular therapies may have a role in the treatment of ruptured infected aneurysm and the treatment of patients at prohibitive risk for open surgery.
How common are mycotic aneurysm?
Mycotic aneurysm of the aorta accounts for 0.7% to 1.3% of all surgically treated aneurysms and its incidence in the aortic arch is less frequent. The prevalence of infected cerebral aneurysms is 0.7%-4% of all patients with cerebral aneurysms.
How does infective endocarditis cause heart block?
Spread of the abscess into the atrial septum was postulated to be the cause of the complete heart block. In endocarditis, the ominous development of heart block and a poor response to antibiotic therapy imply significant extension of the infection.
What kind of infection can cause an aneurysm?
Staphylococcus species (spp) and Salmonella spp are two major bacteria causing infected aneurysm, 28 to 71 percent and 15 to 24 percent of causes, respectively [4,5]. Streptococcus pneumoniae may be the third major, re-emerging, cause of infected aneurysms [6].
How did the mycotic aneurysm get its name?
Mycotic aneurysm. An infected aneurysm is an aneurysm arising from bacterial infection of the arterial wall. It can be a common complication of the hematogenous spread of bacterial infection. William Osler first used the term “mycotic aneurysm” in 1885 to describe a mushroom-shaped aneurysm in a patient with subacute bacterial endocarditis.
How is an infected aneurysm related to endocarditis?
An infected aneurysm is an aneurysm arising from bacterial infection of the arterial wall. It can be a common complication of the hematogenous spread of bacterial infection. William Osler first used the term “mycotic aneurysm” in 1885 to describe a mushroom-shaped aneurysm in a patient with subacute bacterial endocarditis.
Can a mycotic aneurysm cause a cerebral hemorrhage?
Cerebral complications of infective endocarditis (IE) [particularly, mycotic aneurysm, visualized as a hypointense spot on T2*-weighted brain magnetic resonance imaging (MRI)] are associated with a high incidence of postoperative cerebral or subarachnoid hemorrhage.
Which is more accurate mycotic aneurysm or endovascular infection?
According to some authors, a more accurate term might have been endovascular infection or infective vasculitis, because mycotic aneurysms are not due to a fungal organism. Mycotic aneurysms account for 2.6% of aortic aneurysms. For the clinician, early diagnosis is the cornerstone of effective treatment.
