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Multiple mycotic aneurysms of the pulmonary arteries resolving with conservative management: multislice CT

Thuc-Nhi Wilson1, Khimseng Tew, Ajay Taranath

  • 1Department of Radiology, The Queen Elizabeth Hospital, South Australia, Australia.

Journal of Thoracic Imaging
|August 30, 2008
PubMed

Insights

This case study shows conservative antibiotic management for three mycotic pulmonary artery aneurysms in a patient with infective endocarditis, with most resolving over 19 months.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Radiology

Background:

  • Mycotic pulmonary artery aneurysms are rare, life-threatening complications of infective endocarditis.
  • Intravenous drug use is a significant risk factor, often associated with Staphylococcus aureus infections.

Observation:

  • A 22-year-old female with a history of intravenous drug use developed Staphylococcus aureus pneumonia and infective endocarditis.
  • Three mycotic aneurysms in the pulmonary artery were identified and monitored over 19 months using multislice computed tomography.
  • The patient was treated conservatively with antibiotics and remained free of hemoptysis.

Findings:

  • Two smaller aneurysms resolved within 9 weeks.
  • The largest aneurysm showed partial resolution at 19 months but did not completely resolve.
  • Conservative management with antibiotics demonstrated potential efficacy in aneurysm resolution.

Implications:

  • This case highlights the possibility of successful conservative management for mycotic pulmonary artery aneurysms.
  • Long-term imaging follow-up is crucial for monitoring aneurysm progression and resolution.
  • Understanding the natural history and management options for this rare condition is vital for clinical practice.

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