Extracranial mycotic aneurysms in infective endocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Vascular Surgery

Background:

• Infective endocarditis (IE) can lead to serious complications.
• Extracranial mycotic aneurysms (MA) are a rare but significant manifestation of IE.

Purpose of the Study:

• To investigate the incidence, characteristics, and management of extracranial mycotic aneurysms in patients with infective endocarditis.

Main Methods:

• Retrospective follow-up of 217 infective endocarditis patients from October 1978 to February 1984.
• Analysis of patient demographics, etiologic agents, aneurysm locations, diagnostic methods, and treatment outcomes.

Main Results:

• Nine patients (4.15%) developed extracranial MA, predominantly in young males.
• Common causative agents included Streptococcus viridans and Staphylococcus aureus.
• Arterial involvement included limbs (5 cases), thoracic (3 cases), and abdominal (1 case).
• Diagnosis utilized physical examination, imaging (chest roentgenogram, ultrasound, aortography).
• Most patients underwent surgery for MA, with bleeding complications in three cases.
• No limb losses occurred in peripheral MA cases.
• One in-hospital death and one late death due to heart failure were reported.

Conclusions:

• Extracranial mycotic aneurysms are an uncommon but serious complication of infective endocarditis.
• Prompt diagnosis and surgical management are crucial for improving outcomes.
• Further research is needed to optimize treatment strategies and reduce mortality.