Mycotic aneurism for septic embolism in a pediatric patient with acute linfoblastic leukemia
DOI:
https://doi.org/10.35509/01239015.119Keywords:
Aneurysm, false, Infected aneurysm, MycoticAbstract
Pediatric aneurysms are rare and can be caused for damaging of the arterial wall secondary to an infection, forming a blind sacculation contiguous to its lumen called mycotic pseudoaneurysm. The majority of reported cases are from elderly patients with comorbidities. The most frequent involucre microorganisms are Staphylococcus spp, Salmonella spp, Streptococcus spp and rarely fungi.
We present the case of a 3-year-old boy, with a recent diagnosis of acute lymphoblastic leukemia of B precursors in remission, with a high risk of relapse due to incomplete treatment and a history of bacteremia due to Staphylococcus epidermidis and fungemia due to Candida tropicalis; with cardiac vegetations that produce liver, spleen, lung and brain embolism, in whom a partially thrombosed mycotic pseudoaneurysm of the common and external iliac artery is found. The early diagnosis of this entity is of vital importance because of the risk of rupture. Surgical management will depend on the location, size and associated complications.
References
Ahmed Sayed, Ahmed Elsadatand Marwa Mashaal. Aneurysms in pediatric age: a challenging and rare disease entity. Annals of Pediatric Surgery 2015, 11:192–196. https://doi.org/10.1097/01.XPS.0000469363.71793.b5
Lee WT, Mossop PJ, Little AF, Fitt GJ, et al. Infected (Mycotic) Aneurysms: Spectrum of Imaging Appearances and Management. RadioGraphics 2008; 28:1853–1868. https://doi.org/10.1148/rg.287085054
Woodrum DT, Welke KF, Fillinger MF, et al, Candida infectionassociated with a solitary mycotic common iliac artery aneurysm. J Vasc Surg 2001;34:166-8. https://doi.org/10.1067/mva.2001.115381
Rolando Cocio Arcos, Mario Zérega Ruiz, Sebastián Yévenes Aravena, Leonardo Lidid Alonso, Felipe Zumaeta Valenzuela, Alejandro Hollstein Gutiérrez. Septic embolism and embolic source, what and how to look for? URL: http://www.eurorad.org/case.php?id=13289.
León LR, Mills JL. Diagnosis and Management of Aortic Mycotic Aneurysms. Vascular and endovascular Surgery 44(1) 5-13. 2010.https://doi.org/10.1177/1538574409344225
Müller BT, Wegener OR, Grabitz K, et al. Mycotic aneurysms of the thoracic aorta and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg 2001;33:106e13.https://doi.org/10.1067/mva.2001.110356
Peirce C, Coffey C, O’Grady H, Aly S, O’Malley K, O’Donohoe M. The management of mycotic femoral pseudoaneurysms in intravenous drug abusers. Ann Vasc Surg 2009; 23: 345-9. https://doi.org/10.1016/j.avsg.2008.08.013
Semba CP, Sakai T, Slonim SM, et al. Mycotic aneurysms of the thoracic aorta: repair with use of endovascular stentgrafts. J Vasc Interv Radiol. 1998;9:33e40.
Bayer AS, Scheld WM. Endocarditis and intravascular infections. In Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 5 ed. Philadelphia: ChurchillLivingstone; 2000. p. 888-92
Joshi S, Mitta N. Mycotic Aneurysm of Iliac Artery: A Rare Complication of Salmonella Infection. Indian Journal of Vascular and Endovascular Surgery 2014; 1-1. https://doi.org/10.4103/0972-0820.142365
Semin Chonga, Kyung Soo Lee a, Chin A Yia, Myung Jin Chunga,Tae Sung Kima, Joungho Hanb. Pulmonary fungal infection: Imaging fndings in immunocompetent and immunocompromised patients. European Journal of Radiology 59 (2006) 371-83. https://doi.org/10.1016/j.ejrad.2006.04.017
Chandler BT, Ryer EJ, Keyser BM, Elmore JR. A hybrid approach to appendicitis with right external iliac arterypseudo aneurysm: A case report. Int J Surg Case Rep. 2017;33:99-101. https://doi.org/10.1016/j.ijscr.2017.03.001
Brown SL, Busuttil RW, Baker JD, Machleder HI, Moore WS, Barker WF. Bacteriologic and surgical determinants of survival in patients with mycotic aneurysms. J Vasc Surg. 1984;1:541-7. https://doi.org/10.1016/0741-5214(84)90040-5
Chino S, Kato N, Noda Y, Oue K, Tanaka S, Hashimoto T, Higashigawa T, et al. Treatment of infected aneurysms of the abdominal aorta and iliac artery with endovascular aneurysm repair and percutaneous drainage. Ann Vasc Surg.2016; 36:289.e11-289.e15. https://doi.org/10.1016/j.avsg.2016.02.026
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