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Mycotic aneurysm--a rare complication of acute osteomyelitis in a child. A case report
Abstract:
A case of mycotic aneurysm formation of the right iliac artery is described. This unusual complication developed as a result of acute osteitis of the left tibia which was initiated by a kick on the lower leg. One month after treatment for osteitis of the tibia, the patient was readmitted because of unequivocal evidence of ischaemia of the right leg and a large pulsatile mass in the right iliac fossa, confirming the clinical diagnosis of mycotic aneurysm. The aneurysm was excised but because the wall of the artery was extremely friable simultaneous revascularization was deferred for fear of uncontrollable haemorrhage from the anastomotic line.
Insights
A rare mycotic aneurysm of the right iliac artery developed from a tibial osteitis infection. Surgical excision was performed, but revascularization was delayed due to the artery
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Orthopedic Surgery
Background:
- Mycotic aneurysms are rare but serious arterial infections, often originating from distant septic foci.
- Osteitis, an infection of the bone, can rarely lead to secondary complications like mycotic aneurysm formation.
- This case highlights a unique pathway from lower leg osteitis to iliac artery mycotic aneurysm.
Observation:
- A patient presented with symptoms of right leg ischemia and a pulsatile mass in the right iliac fossa.
- Clinical diagnosis confirmed a mycotic aneurysm of the right iliac artery.
- The aneurysm was linked to a preceding acute osteitis of the left tibia, initiated by trauma.
Findings:
- Surgical excision of the mycotic aneurysm was successfully performed.
- The arterial wall was noted to be extremely friable.
- Simultaneous revascularization was deferred due to the high risk of uncontrollable hemorrhage from the anastomotic site.
Implications:
- This case underscores the potential for osteomyelitis to cause distant vascular complications.
- Management of mycotic aneurysms requires careful consideration of arterial wall integrity and hemorrhage risk.
- Delayed revascularization may be a necessary strategy in cases with friable arterial tissue.