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Antibiotic-treated Streptococcus sanguinis intracranial mycotic aneurysm

Ya-Ting Chang1, Cheng-Hsien Lu, Chun-Chung Lui

  • 1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, #123 Ta Pei Road, Kaohsiung, Taiwan.

The Kaohsiung Journal of Medical Sciences
|March 6, 2012
PubMed

Insights

A 33-year-old woman

Area of Science:

  • Neuroendovascular disease
  • Infectious diseases
  • Cardiology

Background:

  • Infective endocarditis (IE) can lead to serious complications, including intracranial mycotic aneurysms (IMAs).
  • Streptococcus sanguinis is a rare cause of IE and IMA.
  • Diagnosis of IMA requires a combination of imaging and microbiological studies.

Observation:

  • A 33-year-old woman presented with symptoms suggestive of IE.
  • Diagnostic workup revealed Streptococcus sanguinis IE with a confirmed intracranial mycotic aneurysm (IMA).
  • Magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), echocardiography, and blood cultures were crucial for diagnosis.

Findings:

  • The patient was treated solely with antimicrobial therapy, including intravenous ceftriaxone and oral penicillin V.
  • Serial MRA studies demonstrated complete regression and disappearance of the IMA.
  • This case highlights the potential for non-surgical management of IE-related IMAs.

Implications:

  • Antimicrobial therapy alone may be sufficient for treating certain cases of intracranial mycotic aneurysms.
  • This approach avoids the risks associated with surgical or endovascular interventions.
  • Further research is warranted to establish guidelines for non-surgical management of IMAs.

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