Mycotic Pulmonary Artery Aneurysm Research Articles

Mycotic pulmonary artery pseudoaneurysm following total arch replacement: a case report

BackgroundAlthough the true prevalence and incidence are not clearly known, mycotic pulmonary artery aneurysm is a potentially devastating condition that leads to high mortality, over 60% if untreated. Among them, mycotic pulmonary artery pseudoaneurysm, which occurs in relatively central areas, has rarely been reported. We report an extremely rare case of a late complication with a mycotic pulmonary artery pseudoaneurysm, presumably due to infective endocarditis, in a 68-year-old woman 4 months after total arch replacement.Case presentationA 68-year-old woman was referred to our department for 2 weeks with fever of unknown origin. She had a history of emergency total arch replacement for an acute type A aortic dissection 4 months earlier and chronic rheumatoid arthritis on monthly subcutaneous tocilizumab treatment for several years. Blood culture was positive for Enterococcus faecalis. Transthoracic and transesophageal echocardiography revealed a left ventricular ejection fraction of 58%, severe mitral regurgitation with a 15-mm diameter vegetation on the anterior mitral leaflet, and severe aortic insufficiency with string-like structures. Contrast computed tomography showed a focal saccular outpouching from the right pulmonary artery. On 18F-fluorodeoxyglucose (FDG) positron emission tomography, focal uptake of FDGs was observed along the same lesion of the pulmonary artery and ascending-arch graft. The patient eventually recovered after the surgical intervention of mitral and aortic valve replacement, re-total arch replacement, pulmonary artery repair, application of omental flap, and antibiotics without any evidence of re-infection after 1 year.ConclusionsWe report a successful surgical repair of mycotic pulmonary artery pseudoaneurysm 4 months after total arch replacement for acute type A aortic dissection. This report describes an effective treatment for an extremely rare postoperative condition.

MYCOTIC PULMONARY ARTERY ANEURYSM SECONDARY TO SEPTIC EMBOLI: A POTENTIALLY LIFE-THREATENING COMPLICATION OF INFECTIVE ENDOCARDITIS

MYCOTIC PULMONARY ARTERY ANEURYSM SECONDARY TO SEPTIC EMBOLI: A POTENTIALLY LIFE-THREATENING COMPLICATION OF INFECTIVE ENDOCARDITIS

Right Sided Infective Endocarditis and Mycotic Pulmonary Artery Aneurysm- A Brief Review of Important Literature

Right-sided infective endocarditis (IE) involves the infection of the endocardial surface of either the tricuspid or pulmonary valve. The tricuspid valve is involved in almost 90% of cases. Isolated right-sided infective endocarditis can present with multiple complications; the most common of which include valvular insufficiency, abscess formation, and septic pulmonary embolism. Other complications include pulmonary infarcts, pleural effusion, empyema, and pneumothorax. Mycotic pulmonary artery aneurysm is a rare complication of right-sided infective endocarditis. Staphylococcus and Streptococcus species are the most common culprits for mycotic pulmonary artery aneurysms. IV drug use and bacterial endocarditis are the two major known risk factors for mycotic aneurysm. Computerized tomography angiography is the mainstay of imaging modalities to diagnose mycotic pulmonary artery aneurysms. MRI angiography can also be used to diagnose mycotic pulmonary aneurysms, but this imaging modality is not available widely. The mycotic pulmonary aneurysm is treated both surgically and conservatively depending on the symptoms and clinical status of the patient. The surgical approach includes emergent arterial embolization, lobectomy, resection, banding, and aneurysmectomy.

P5‐109: A fatal case of multiple mycotic pulmonary artery aneurysms due to Aspergillus terreus in a post COVID‐19 patient

P5‐109: A fatal case of multiple mycotic pulmonary artery aneurysms due to <i>Aspergillus terreus</i> in a post COVID‐19 patient

Pulmonary mucormycosis causing a mycotic pulmonary artery aneurysm

Mycotic pulmonary artery aneurysms requiring pneumonectomy are extremely rare. We present a severely breathless immunocompromised diabetic middle-aged female patient. CT pulmonary angiogram revealed a giant pulmonary artery aneurysm with impending rupture in the right lung. We did an emergency right pneumonectomy under cardiopulmonary bypass support. Histopathology report of the lung specimen confirmed mucormycosis. She received amphotericin B after the procedure. The patient had a prolonged postoperative hospital stay and succumbed to sepsis. Mycotic pulmonary artery aneurysm portends very high morbidity and mortality in immunocompromised patients.

Fatal Mycotic Pulmonary Artery Aneurysms in Patients with Congenital Heart Disease Complicated by Right-Sided Infective Endocarditis

Mycotic aneurysms of pulmonary arteries are potentially fatal conditions occurring in patients ith congenital heart disease complicated by infective endocarditis folloing surgery or interventions. Presentation is indolent and symptoms may be nonspecific. Unless suspected and investigated ith computed tomography, they are missed until their advanced stage. Treatment options are limited as shon in to patients presented in this report.

P13 Massive Haemoptysis and Recurrent Infective Endocarditis in an Intravenous Drug User; A Case Report

Intravenous drug users (IVDU) are at a higher risk of serious complications such Infective Endocarditis (IE), which has high morbidity and mortality rates [1]. Mycotic pulmonary artery aneurysms (MPAA) are rarely associated with right-sided IE, especially in IVDU [2]. It is a potentially fatal complication, since it can cause severe haemorrhage if the aneurysm ruptures.

Aspergillus Mimicking a Rasmussen Aneurysm in an Immunocompromised Setting Causing Massive Hemoptysis

Abstract Aspergillus is a ubiquitous mold found in diverse environments but is mostly limited to infectious complications in immunocompromised patients. Invasive pulmonary aspergillosis (IPA) is a common infection in leukemic patients with prolonged neutropenia. However, mycotic pulmonary artery aneurysm (PAA) is a very rare complication of IPA. We describe the case of a 58-year-old patient with prolonged neutropenia and leukemia who developed invasive aspergillosis, followed by unexpected massive hemoptysis and terminal exsanguination. Surgical resection of IPA in leukemic patients is rarely performed because of early recognition and initiation of preemptive potent antifungals, pancytopenia, bleeding diathesis, and delayed wound healing. Historically, tuberculosis and syphilis were major causes of PAA, but their incidence has decreased significantly since the advent of effective antibiotics. We review nontuberculous causes of PAA and outline the pathology, diagnosis, and treatment options currently available. Currently, Staphylococcus species, Streptococcus species, and Aspergillus species account for 70% cases of PAA.

Intravenous drug use causing Enterococcus Faecalis bacteraemia, mycotic pulmonary artery aneurysm and suspected Mucormycosis

Background 33 year old previously fit and well lady with a history of previous drug use presented generally unwell with shortness of breath and cough. Methods Initial investigations demonstrated marked inflammatory response with bilateral pneumonia on chest xray. She was initially treated for severe community acquired pneumonia. On day 3 of admission blood cultures isolated Enterococcus faecalis, which was later also isolated in sputum. Results Transthoracic echo demonstrated no evidence of vegetations to suggest endocarditis. Despite appropriate antibiotic switch inflammatory markers increased, and a groin abscess was suspected on clinical examination leading to CT angiogram in addition to CT thorax. Imaging demonstrated left ileofemoral DVT and a large pulmonary artery aneurysm with multiple cavitating pulmonary lesions. Following discussion with cardiothoracics the patient was transferred to a cardiothoracic centre for left lower lobectomy and lingulectomy. Histopathological perioperative samples showed branching fungal hyphae within multiple blood vessels, although 18s PCR returned as negative. The patient had a good clinical response with IV Amoxicillin and antifungal therapy - Oral Posaconazole was used as she suffered an adverse reaction to liposomal Amphotericin B. Discussion Final impression was of mycotic pulmonary artery aneurysm caused by Enterococcus faecalis with suspected mucormycosis as result of intravenous drug use. This case highlights the increased risk of mucormycosis in people who inject drugs.

Giant mycotic pulmonary artery aneurysms in a newborn

We present the case of a 2-month-old male infant who underwent surgical repair of oesophageal atresia on Day 2 after birth, necessitating a long-term central venous catheter for parenteral nutrition. After 2 months, he presented with fever and haemoptysis. Transthoracic echocardiography identified a large, highly mobile mass located in the right …

A Mycotic Pulmonary Artery Aneurysm Associated withCandidaEndocarditis: Case Report

Infectious or mycotic pulmonary artery aneurysms (PAAs) are rare vascular abnormalities triggered by a variety of microorganisms, particularly of the bacteria including Staphylococcus aureus and Streptococcus species, and rarely by fungi such as Aspergillus and Candida species (1). PAAs are often associated with infective endocarditis or pneumonia, and PAA patients suffer high mortality (2). Early diagnosis and prompt intervention are important to prevent life-threatening hemorrhage (3). However, the diagnosis of a mycotic pulmonary artery aneurysm can be difficult in the absence of pneumonic consolidation adjacent to the aneurysm, or cavitary nodules which are suggestive of septic embolism. We present a case of an infectious pulmonary arterial aneurysm with Candida endocarditis in a patient initially diagnosed with vasculitis. We review the literature on the etiology, radiologic findings, and management of the condition. CASE REPORT

Hemoptysis Due to a Mycotic Pulmonary Artery Aneurysm in an Injecting Drug User

Infected aneurysms of the pulmonary artery are a rare consequence of injected drug use. Hemoptysis of pulmonary arterial origin is also infrequent; however, the mortality is as high as 50%. We report here a case of hemoptysis in an intravenous drug user, caused by a pulmonary artery aneurysm due to septic microemboli, originating from a groin abscess. We highlight the importance of recognizing and treating thromboembolic complications associated with deep venous thrombosis in injecting drug users.

Multiple Mycotic Aneurysms of the Pulmonary Arteries Resolving With Conservative Management

Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endocarditis. Three mycotic aneurysms developed in a 22-year-old female patient who had a history of intravenous drug use. She suffered from Staphylococcus aureus pneumonia and infective endocarditis. The patient was managed conservatively with antibiotics. She did not have hemoptysis during a prolonged hospital stay. Several multislice computed tomography examinations were performed to follow these aneurysms over a period of 19 months. The 2 smaller aneurysms had resolved by 9 weeks postdevelopment. The largest aneurysm was stable at 9 weeks and was smaller at 19 months, but it had not yet completely resolved. The literature on this rare condition was reviewed and its prognosis and management were discussed.

Mycotic pulmonary artery aneurysm as a late complication of infective endocarditis after pacemaker implantation

A 49-year-old-woman who had had a pacemaker implanted 15 years earlier became acutely ill with a continuous high fever and general fatigue. A pulmonary artery aneurysm had been rapidly developing and had arrived at the acute phase within 2 weeks. After removal of the pacemaker and with antibiotic therapy the aneurysm gradually decreased in size and has been without rupture for 3 years. Conservative treatment seemed to be sufficient for the management of a mycotic aneurysm in this case.

Pulmonary Complications of Illicit Drug Use

The aim of this manuscript is to summarize an approach to the differential diagnosis of the pulmonary complications of illicit drug use based on the computed tomography findings. The various pulmonary complications of illicit drug use result in 5 main patterns of parenchymal abnormality: nodules, ground-glass opacities, consolidation, air trapping, and emphysema. Other thoracic manifestations of illicit drug use include pulmonary arterial hypertension, pneumomediastinum, bacterial endocarditis, discitis, and septic arthritis.

Mycotic pulmonary artery aneurysm diagnosed 18 years after bacterial endocarditis

A 21-year-old woman with a history of bacterial endocarditis and ventricular septum defect repair was referred for evaluation of a mass in the right mid-lung field. A contrast-enhanced computed tomography scan of the chest showed an aneurysm of the right lateral pulmonary artery. The aneurysm was considered to be mycotic in origin. The aneurysm was treated by coil embolization using 19 detachable coils measuring 425 cm in overall length.

肺動脈絞扼術後に感染性肺動脈瘤から主肺動脈右肺動脈ろうを呈した１例

肺動脈絞扼術後に感染性肺動脈瘤から主肺動脈右肺動脈ろうを呈した１例

Mycotic aneurysm of pulmonary artery: A rare complication of empyema

Summary We report a case of mycotic aneurysm of pulmonary artery secondary to Streptococcus intermedius pneumonia and empyema. A 77-yr-old male patient was admitted with left lower lobe pneumonia and empyema. He subsequently developed respiratory failure and required mechanical ventilation. After prolonged stay in intensive care unit his respiratory status improved and he was extubated. CT of chest with intravenous contrast showed left distal pulmonary artery aneurysm. The patient declined any intervention. Unfortunately, 2 days after extubation the patient developed massive hemoptysis and died.

A Mycotic Pulmonary Artery Aneurysm Presenting as an Endobronchial Mass

We report the case of a 49-year-old woman who developed an endobronchial mycotic pulmonary artery aneurysm (PAA) as a complication of pneumonia. After presenting with patchy infiltrates, she developed right lung atelectasis. A noncontrast chest CT scan revealed a mass in the right hilum, and bronchoscopy identified an obstructing lesion in the right mainstem bronchus. Unfortunately, biopsy caused massive hemorrhage, and the patient died. An autopsy identified a mycotic PAA that had invaded the right mainstem. The case suggests that a contrasted CT scan should be included in the evaluation of endobronchial masses and that PAA should be included in the differential diagnosis of such lesions.

Mycotic pulmonary artery aneurysm following pulmonary artery banding

A neonate with situs inversus, transposition of the great arteries, ventricular septal defect, criss-cross ventricles and hypoplastic right ventricle underwent pulmonary artery banding at the age of 7 days. The course was complicated by septicaemia and subsequently the development of an aneurysm of the pulmonary artery. Serratia marcessans was grown from the band site. The pulmonary artery aneurysm was resected and the pulmonary artery was repaired. The literature is reviewed with the emphasis on diagnosis, natural history and surgical management.