Document Detail


Pseudomonas aeruginosa intrapetrous internal carotid artery mycotic aneurysm--a complication of mastoiditis: first reported case.
MedLine Citation:
PMID:  23843414     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Mycotic aneurysms of the intrapetrous carotid artery are a rare complication of adjacent middle ear infections that occur by direct invasion of arterial adventitia. We report the first case of a Pseudomonas aeruginosa mycotic intrapetrous carotid aneurysm arising from mastoiditis, confirmed with middle ear cultures, presenting with high-grade bacteraemia and otorrhagia in a diabetic man. Infection was related to elective myringotomy tube placement and was initially treated with empiric antibiotics. Diagnosis required careful evaluation of imaging studies, particularly MR angiography. Resolution required aggressive debridement and carefully selected long-term intravenous antibiotics, appropriate for carefully determined antibiotic sensitivity of his pathogen, but no neurosurgical intervention. He has had no evidence of recurrence over the subsequent year. We offer our experience to highlight the dangers of invasive P aeruginosa middle ear infections in patients with diabetes to other practitioners and to encourage earlier, more aggressive intervention.
Authors:
Alyssa S Shon; Charles S Berenson
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Publication Detail:
Type:  Journal Article     Date:  2013-07-09
Journal Detail:
Title:  BMJ case reports     Volume:  2013     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2013  
Date Detail:
Created Date:  2013-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
Affiliation:
Infectious Disease Division, Department of Veterans Affairs Western New York Healthcare System, State University of New York at Buffalo, Buffalo, New York, USA.
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