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Mycotic aortic aneurysm presenting as multiple cerebral abscesses

M Pocar1, A Moneta, S Pelenghi

  • 1Istituto di Malattie dell'Apparato Cardiovascolare e Respiratorio, Università degli Studi di Milano, Italy.

Acta Neurochirurgica
|June 25, 1998
PubMed
Summary

A rare case of aortic infection presented as multiple brain abscesses in a 68-year-old man. This mycotic aneurysm likely stemmed from a prior cardiac surgery, highlighting a unique diagnostic challenge.

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Cardiology

Background:

  • Cerebral abscesses can arise from various sources, including endocarditis and septic emboli.
  • Aortic infections, such as mycotic aneurysms, are uncommon but serious conditions.

Observation:

  • A 68-year-old male presented with multiple cerebral abscesses.
  • Initial investigations, including echocardiography and chest radiography, did not identify intrathoracic embolic sources.
  • The primary brain lesion was surgically excised.

Findings:

  • Neurological deterioration prompted further imaging.
  • Computerized tomography revealed a mycotic aneurysm of the ascending aorta.
  • The aortic infection was suspected to be related to a previous cardiac operation.

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Implications:

  • This case represents the first reported instance of an aortic infection manifesting as multiple brain abscesses.
  • It underscores the importance of considering unusual sources for cerebral abscesses, particularly in patients with cardiac history.
  • Early diagnosis and management of mycotic aneurysms are critical to prevent catastrophic complications.