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Mycotic aneurysms of the tibioperoneal arteries
1Division of General Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Abstract:
This case report describes a pediatric patient with mycotic aneurysms of both posterior tibial arteries and the right peroneal artery associated with an episode of endocarditis. To our knowledge, this case represents the first reported occurrence of multiple mycotic aneurysms of the tibioperoneal arteries. It is also unique in that the pathogen was Brucella canis instead of the usual gram-positive pathogens associated with intravenous drug injection. Vascular reconstruction can be accomplished; however, management of this complex problem should be individualized.
Insights
This case report details a rare instance of multiple pediatric mycotic aneurysms in the lower leg arteries caused by Brucella canis endocarditis. Management requires individualized vascular reconstruction strategies.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Pediatric Cardiology
Background:
- Mycotic aneurysms are rare arterial infections, often linked to endocarditis.
- Tibioperoneal artery involvement is exceptionally uncommon in pediatric cases.
- Brucella canis endocarditis is an unusual etiology for vascular complications.
Observation:
- A pediatric patient presented with multiple mycotic aneurysms affecting the posterior tibial and peroneal arteries.
- The patient had a preceding episode of endocarditis.
- The causative agent identified was Brucella canis.
Findings:
- This is the first reported case of multiple mycotic aneurysms specifically in the tibioperoneal arteries in a pediatric patient.
- The identification of Brucella canis as the pathogen is unique, differing from typical gram-positive organisms often seen in intravenous drug users.
- Successful vascular reconstruction was achieved, though challenging.
Implications:
- This case expands the known spectrum of mycotic aneurysm presentation in pediatric patients.
- It highlights the importance of considering Brucella canis in endocarditis cases with unusual vascular manifestations.
- Individualized treatment approaches are crucial for managing complex tibioperoneal mycotic aneurysms.