Mycotic aneurysm

More exceptional causes, including breakdown of the arterial anastomosis or rupture of an arterial aneurysm (mycotic or not). 

Heart murmurs are heard frequently on auscultation (over 85% of cases), but a new murmur or change in murmurs is only found in 5% to 10 % or 3% to 5 %, respectively.1 Additionally, over 90% of patients who have a new murmur will develop congestive heart failure, which is a major cause of morbidity and mortality. Splenomegaly and mycotic aneurysms also are noted in many cases of IE. 

Vascular phenomena, major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway s lesions... 

Spinal subarachnoid hemorrhage is very rare. It is caused by a vascular malformation, hemostatic failure, coarctation of the aorta, inflammatory vascular disease, mycotic aneurysm or a vascular tumor such as ependymoma. Accumulating hematoma may compress the spinal cord. Suspicion is aroused if the cerebral angiogram is negative and the patient develops spinal cord signs. 

Ferrari, A.R, Ferreira, J.RA., de Panio, GA., della Libera, E. Hemo-bilia caused by a mycotic aneurysm of the hepatic artery treated by enbucrilate injection during ERCP (case report). Gastrointest. Endosc. 2003 57 260 - 263... 

Other rare complications have been seldom reported, namely cryoglobulinemia with evidence of disseminated BCG infection (16), ruptured mycotic aneurysm of the abdominal aorta (17), bladder wall calcification (18), rhabdomyolysis (19), iritis or conjunctivitis with arthritis or Reiter s syndrome (20,21), and severe acute renal insufficiency due to granulomatous interstitial nephritis, which can occur even in the absence of other systemic complications (22). 

A mycotic aneurysm, a rare complication of intravesical BCG therapy, has been reported (17). 

Damm O, Briheim G, Hagstrom T, Jonsson B, Skau T. Ruptured mycotic aneurysm of the abdominal aorta a serious complication of intravesical instillation Bacillus Calmette-Guerin therapy. J Urol 1998 159(3) 984. 

Mycotic aneurysms aneurysm usually due to bacterial infections... 

Atrial fibrillation with mitral valve disease has long been considered a stroke risk factor. Recurrent embolism occurs in 30-65% of patients with rheumatic mitral valve disease who have a history of a previous embolic event. Most of these recurrences (around 60%) develop within the first year. Mechanical prosthetic valves are a prime site for thrombus formation and patients with these valves require anticoagulation [7, 38]. Bacterial endocarditis can cause stroke as well as intracerebral mycotic aneurysms. Because mycotic aneurysms are inflammatory defects in the vessel wall, treatment with systemic thrombolysis or anticoagulation can lead to rupture with subsequent lobar hemorrhage. Nonbacterial, or marantic, endocarditis is also associated with multiple embolic strokes. This condition is most common in patients with mucinous carcinoma and may be associated with a low-grade disseminated intravascular coagulation. A nonbacterial endocarditis, called Libman-Sacks endocarditis, occurs in patients with systemic lupus erythematosus (SLE) [42],... 

Aneurysm Iatrogenic trauma (post-operative, post-bile duct intervention, post-liver biopsy) Accidental trauma Pancreatitis (proteolysis, pseudocyst) Mycotic Arteriitis (polyarteriitis nodosa etc.) Collagen tissue disorder (Ehler Danlos etc.)... 

The first infectious intracranial aneurysm was probably described by Church in 1869 when he established a relationship between an intracranial aneurysm and infectious endocarditis. The term infectious aneurysm should be preferred bacterial or mycotic should be used only if bacteria or fungi are demonstrated as the causative organisms. The frequently used term mycotic is misleading in the vast majority of patients because bacterial infection represents the most common cause for infectious... 

Brust JC, Dickinson PC, Hughes JE, Holtzman RN (1990) The diagnosis and treatment of cerebral mycotic aneurysms. Ann Neurol 27 238-246... 

Chapot R, Houdart E, Saint-Maurice JP, Aymard A, Mou-nayer C, Lot G, Merland JJ (2002) Endovascular treatment of cerebral mycotic aneurysms. Radiology 222 389-396 Chason J, Hindman W (1958) Berry aneurysms of the circle of Willis results of a planned autopsy study. Neurology 8 41-44... 

Infected (mycotic) aneurysms can be identified by its lobulated contour, soft tissue infiltration, and periaortic abscesses or trapped air (Rakita et al. 2007). Primary aorto-enteric fistulas as a complication of an AAA are rare and can be identified by extraluminal periaortic trapped air or by the extravasation of the contrast agent into the gastrointestinal tract. 

Mycotic aneurysms from bacterial endocarditis were initially the most common cause of hepatic artery aneurysm [11]. However, traumatic and iatrogenic causes are likely the most common etiology today. Medial degeneration and atherosclerotic changes have also been implicated. However, atherosclerosis is more likely the result rather than the cause of the... 

Generally, SMA aneurysms are mycotic, celiac aneurysms develop from cystic medial degeneration, GDA pseudoaneurysms occur in the presence of duodenal ulceration, and gastroepiploic and pancreaticoduodenal aneurysms arise secondary to inflammatory changes from pancreatitis. Other causes include polyarteritis nodosa, amphetamine abuse, and connective tissue disorders. 

Knosalla C, Weng Y, Warnecke H et al (1996) Mycotic aortic aneurysms after orthotopic heart transplantation. J Heart Lung Transplant 15 827-839 Kohashigawa JA, Kirklin JK, Naftel DC et al (1993) The Transplant Cardiologists Research Database Group pretransplantation risk factors for acute rejection after heart transplantation - a multi-institutional study. J Heart Lung Transplant 12 355-366... 

Fig. 3.15a, b. Perigraft hematoma secondary to the rupture of a mycotic aneurysm, a Contrast-enhanced CT shows a dense collection (thick arrow) at the lower pole of the transplant surrounding the renal artery, b Gd-enhanced MR angiography shows the aneurysm close to the arterial anastomosis (thin arrow)... 

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