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Mycotic aortic aneurysms in children
Abstract:
Mycotic aneurysms of the aorta are uncommon in babies and children. Prior to the development of antibiotics, most mycotic aneurysms were seen secondary to bacterial endocarditis, but this is now uncommon. Instead, more cases have been reported as complications of umbilical artery catheters in newborns. We have seen five cases of mycotic aneurysms in children, two of them secondary to umbilical artery catheters. One patient had coarctation of the aorta, and the other patients had different sources of infection. Three patients were treated surgically by us with good results after antibiotic therapy. One patient died of sepsis before the aneurysm was diagnosed. The fifth patient was treated elsewhere and now has a recurrent aneurysm. We think a combination of aggressive medical and early surgical therapy may save a high percentage of these patients.
Insights
Mycotic aneurysms in children are rare but serious. Early diagnosis and a combined approach of antibiotics and surgery can improve outcomes for these aortic conditions.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Mycotic aneurysms of the aorta are rare in pediatric populations.
- Historically linked to bacterial endocarditis, now more frequently associated with umbilical artery catheter complications in neonates.
Observation:
- A review of five pediatric cases of mycotic aortic aneurysms was conducted.
- Two cases were secondary to umbilical artery catheters; one patient had coarctation of the aorta.
- Infections arose from various sources, highlighting diverse etiologies.
Findings:
- Three patients underwent successful surgical treatment combined with antibiotic therapy.
- One patient succumbed to sepsis prior to diagnosis, underscoring the urgency.
- One patient experienced a recurrent aneurysm after treatment elsewhere.
Implications:
- Aggressive medical management, including antibiotics, is crucial.
- Early surgical intervention alongside medical therapy may significantly improve survival rates.
- Increased vigilance for mycotic aneurysms in neonates with umbilical artery catheters is warranted.