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Mycotic aneurysm of the renal transplant artery

Shiro Fujikata1, Nozomu Tanji, Tokuhiro Iseda

  • 1Department of Urology, Ehime University School of Medicine, Ehime, Japan. c-sfujikata@eph.pref.ehime.jp

International Journal of Urology : Official Journal of the Japanese Urological Association
|July 13, 2006
PubMed

Insights

A case of mycotic aneurysm in a renal transplant patient due to Methicillin-resistant Staphylococcus aureus septicemia was successfully managed conservatively. This unique approach avoided rupture and complications, offering a new treatment possibility.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Renal transplantation is a life-saving procedure for end-stage renal failure.
  • Septicemia can lead to serious complications, including mycotic aneurysms.
  • Mycotic aneurysms in transplant recipients pose significant management challenges.

Observation:

  • A 59-year-old male, post-renal transplant, developed fever and signs of infection at an IV site.
  • Blood and pus cultures identified Methicillin-resistant Staphylococcus aureus (MRSA).
  • Initial computed tomography (CT) did not detect a mycotic aneurysm on the transplant artery.

Findings:

  • After MRSA septicemia treatment, a 4 cm pseudoaneurysm was identified at the anastomosis of the renal transplant and external iliac arteries via CT.
  • The patient was managed conservatively with careful follow-up.
  • This represents the first reported case of a conservatively managed mycotic aneurysm with an uneventful, non-ruptured outcome.

Implications:

  • Conservative management may be a viable option for select cases of mycotic aneurysms in renal transplant recipients.
  • Early detection and prompt treatment of septicemia are crucial in transplant patients.
  • This case highlights the importance of vigilant monitoring for vascular complications post-transplant, even after initial infection resolution.

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