Document Detail

Mycotic embolism and embolomycotic aneurysms. Neglected lessons of the past.
MedLine Citation:
PMID:  3755884     Owner:  NLM     Status:  MEDLINE    
During the past decade, nine patients with bacterial endocarditis have required management of mycotic emboli and/or aneurysms in this center. In these patients, 25 separate mycotic emboli or aneurysms were identified. Among these were four visceral, 11 lower extremity, one aortic, one hypogastric, and eight cerebral lesions. Multiple sites were involved in seven of the nine patients (78%). Presenting symptoms were secondary to acute expansion of mycotic aneurysms in three patients and secondary to rupture of aneurysms in four patients. Mycotic emboli produced cerebral infarction in two patients and acute ischemia in six patients. Asymptomatic mycotic aneurysms of the middle cerebral, hepatic, hypogastric, and profunda femoris arteries and asymptomatic emboli to the profunda femoris and tibial arteries were found during angiographic study. Management included resection alone (7 aneurysms), resection and graft replacement (2 aneurysms and 2 emboli), embolectomy (2), or observation. There was no mortality or loss of limb in these patients. This experience underscores the frequent multiplicity of mycotic emboli and/or aneurysms and stresses the importance of empiric angiographic survey to exclude silent yet potentially lethal visceral and cerebral mycotic foci in patients with bacterial endocarditis and peripheral emboli or aneurysms.
R H Dean; G Waterhouse; P W Meacham; F A Weaver; J A O'Neil
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  204     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1986 Sep 
Date Detail:
Created Date:  1986-10-08     Completed Date:  1986-10-08     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  300-7     Citation Subset:  AIM; IM    
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MeSH Terms
Aneurysm, Infected / etiology*,  surgery
Child, Preschool
Embolism / etiology*,  surgery
Endocarditis, Bacterial / complications*,  etiology,  therapy
Middle Aged
Rupture, Spontaneous

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