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Mycotic visceral aneurysm complicating infectious endocarditis: Imaging diagnosis and follow-up

Massimo Tonolini1, Marina Petullà, Roberto Bianco

  • 1Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157 Milan, Italy.

Journal of Emergencies, Trauma, and Shock
|July 13, 2012
PubMed

Insights

Infected aneurysms, a rare endocarditis complication, pose life-threatening risks due to potential rupture. Prompt CT detection and regular imaging surveillance are crucial for managing these unpredictable vascular lesions.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Infected (mycotic) aneurysms are rare but dangerous complications of endocarditis.
  • They arise from septic emboli, often seen in patients with valve issues, IV drug use, diabetes, or HIV.
  • These aneurysms are frequently unsuspected but carry high risks of sepsis and rupture.

Purpose of the Study:

  • To highlight the diagnostic and management challenges of mycotic aneurysms.
  • To emphasize the role of advanced imaging in detecting and monitoring these lesions.

Main Methods:

  • Review of clinical presentations and imaging findings of mycotic aneurysms.
  • Focus on the utility of contrast-enhanced multidetector computed tomography (CT) for diagnosis and planning.
  • Discussion of the importance of follow-up imaging, including CT and color Doppler ultrasound.

Main Results:

  • Contrast-enhanced multidetector CT enables prompt detection, characterization, and vascular mapping of mycotic aneurysms.
  • Imaging facilitates planning for surgical or interventional therapies.
  • Mycotic aneurysms exhibit unpredictable behavior, including spontaneous thrombosis, growth, or rupture.

Conclusions:

  • Mycotic aneurysms are life-threatening and require vigilant management.
  • Multidetector CT is essential for initial diagnosis and treatment planning.
  • Continuous imaging surveillance with CT and/or ultrasound is necessary due to the unpredictable nature of these aneurysms.
Keywords:
Endocarditismesenteric arterymycotic aneurysmsepsisvisceral aneurysm

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