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Successful treatment of primary pneumococcal multilocular mycotic aneurysms
D Grandmougin1, H Warembourg, G Fayad
1Service de Chirurgie Thoracique et Cardio-vasculaire, Hôpital Cardiologique (CHRU-LILLE), Lille, France.
Abstract:
We report the case of a patient with five primary pneumococcal multilocular mycotic aneurysms located in the left femoral artery, the descending thoracic aorta and the right internal iliac artery. A successful treatment combining three different procedures was performed, including the use of two cryopreserved thoracic homografts. At a 54-month follow-up, the patient is alive and leads a normal life. Regular evaluation including computed tomographic scans of the thorax and abdomen showed no recurrence of infectious aneurysmal process. Moreover, this latter examination confirmed no dilatation nor significant calcifications of the thoracic arterial allograft, though chest roentgenogram showed discrete calcifications along the borders at the 50th month.
Insights
This study details a successful treatment for five primary pneumococcal mycotic aneurysms using multiple procedures and cryopreserved homografts. The patient remains healthy with no recurrence at 54-month follow-up.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Cardiology
Background:
- Mycotic aneurysms are rare, life-threatening infections of arterial walls, often caused by bacteria.
- Pneumococcal infections can lead to mycotic aneurysms, posing significant surgical challenges.
Observation:
- A patient presented with five primary pneumococcal multilocular mycotic aneurysms in major arteries: left femoral, descending thoracic aorta, and right internal iliac.
- The aneurysms were complex, requiring a multi-procedural treatment approach.
Findings:
- A combination of three distinct surgical procedures was successfully employed for treatment.
- Two cryopreserved thoracic arterial homografts were utilized in the surgical repair.
- At 54 months post-treatment, the patient exhibited no signs of recurrence and maintained a normal life.
Implications:
- This case highlights the feasibility of complex reconstructive surgery for multiple mycotic aneurysms.
- Long-term follow-up confirmed the durability of homograft use and the absence of infectious recurrence.
- Successful management offers hope for patients with similar rare and severe vascular infections.