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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced two cases of infective endocarditis associated with cerebral mycotic aneurysm. Case 1: 58 year-old man underwent emergency aortic and mitral valve replacement due to active infective endocarditis and congestive heart failure diagnosed by transesophageal echocardiography. After the operation, he did not wake up and his bilateral pupils were dilated. Computed tomography demonstrated massive intracranial hemorrhage and severe brain edema. He died from multiple organ failure 22th postoperative day. Rupture of cerebral mycotic aneurysm was strongly suspected. Case 2: 56 year-old man was admitted with severe headache and high grade fever. Computed tomography demonstrated intracranial hemorrhage. Cerebral mycotic aneurysm was detected at left distal middle cerebral artery by cerebral angiography. Infective endocarditis and mitral regurgitation were also diagnosed by echocardiography. He underwent cerebral mycotic aneurysmectomy after intensive antibiotics therapy, followed by successful mitral valve replacement. We review the literatures and discuss the problems of surgical management of infective endocarditis with cerebral mycotic aneurysm.
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PMID:[Surgical treatment of infective endocarditis associated with cerebral mycotic aneurysm]. 922 58

This report describes a case involving mycotic aneurysm of the extracranial internal carotid artery occurring as a complication of staphylococcal endocarditis in a patient with systemic lupus erythematosus. Three main points are emphasized: (1) this complication occurred in an immunodepressed patient; (2) surgical treatment consisted of aneurysmorraphy using absorbable suture; (3) the outcome was successful with a follow-up of 24 months.
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PMID:Mycotic aneurysm of the extracranial carotid artery: an uncommon complication of bacterial endocarditis. 936 11

A 39-year-old female with mitral valve prolapse experienced left side hemisensory disturbance four months after gastric surgery. Echocardiogram disclosed vegetation on the mitral valve and blood cultures showed growth of enterococcus. With a diagnosis of thalamic infarction complicating infective endocarditis, she was hospitalized for further treatment. After four weeks of antibiotic therapy, she developed sudden headache and obtundation. Imaging studies revealed intracerebral hemorrhage (ICH), resulting from mycotic aneurysm rupture. She survived and recovered after emergency craniotomy and evacuation of the hematoma. However, the ICH recurred six weeks later and the patient died after five days in a deep coma. Patients with mitral valve prolapse are common. Those who have systolic murmur or valvular thickening and redundancy are at particular risk of infective endocarditis and should receive antibiotic prophylaxis perioperatively as recommended by the American Heart Association. Clinical manifestations of infective endocarditis and its complications, as in our patient, are often trivial. Prompt diagnosis and intervention are crucial. In view of the poor prognosis associated with ICH due to mycotic aneurysm rupture, we suggest cerebral angiography be performed in patients presenting with focal neurologic deficits or with warning headache for early detection of accessible lesions for excision.
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PMID:Infective endocarditis complicated with thalamic infarction and mycotic aneurysm rupture: a case report. 950 94

We report a 24-year-old man with mitral valve endocarditis complicated by acute myocardial infarction due to coronary embolism. Percutaneous transluminal coronary angioplasty and subsequent mitral valve replacement were performed. Postoperative coronary angiography revealed formation of a mycotic aneurysm of the left anterior descending coronary artery at the site of balloon inflation. The patient then underwent successful resection of the aneurysm with coronary artery bypass grafting.
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PMID:Mycotic aneurysm of the left coronary artery. 952 31

Two patients are described with a mycotic aneurysm caused by streptococcus pneumoniae infection. The patients presented with back pain and fever, and had an antecedent history of lower respiratory tract infection; neither of them were suffering from endocarditis. Mycotic aneurysms are a rare disorder with, over the years, a changing spectrum of presentation, localisation and bacterial aetiology. S. pneumoniae infection has only very rarely been reported as a cause of mycotic aneurysms. Since 1986, 14 patients with a mycotic aneurysm were treated at the Leiden University Hospital. Of these patients, 5 had mycotic aneurysms caused by S. pneumoniae infection. The mortality in these patients was high. In this communication, we would like to draw attention to S. pneumoniae infections as an emerging cause of mycotic aneurysms.
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PMID:Streptococcus pneumoniae, an emerging pathogen in mycotic aneurysms? 957 37

Endocarditis requiring surgical intervention in children is uncommon. Individualized operative therapy must be fashioned to the particular pathology of each case. In this case we describe mitral anterior leaflet homograft patch augmentation valvuloplasty, subaortic homograft patch closure of a large mycotic aneurysm, and homograft aortic root replacement in a 3-year-old patient with endocarditis after remote repair of complete atrioventricular canal.
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PMID:Repair of mitral valve and subaortic mycotic aneurysm in a child with endocarditis. 964 10

A case is reported of a brain abscess and an intracranial mycotic aneurysm associated with infective endocarditis caused by streptococcus intermedius. A 60-year-old man with a history of fever presented aphasia and right hemiparesis. A computed tomographic scan of the head revealed a low-density area with ring enhancement in the left parietal lobe consistent with a brain abscess. An angiography demonstrated an aneurysm on the distal branch of the middle cerebral artery compatible with a mycotic aneurysm. Doppler echo cardiography showed severe mitral regurgitation by chordal ruptures. The brain abscess and intracranial mycotic aneurysm were resolved under appropriate antibiotic therapy for eight weeks. Then, the mitral valve was reconstructed by replacement of the chordae tendineae with expanded polytetrafloroethylene suture and annuloplasty. The patient had no neurologic deficit except for paresthesia in the right hand, and had no mitral regurgitation at discharge.
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PMID:[A mitral valve reconstruction of infective endocarditis with brain abscess and intracranial mycotic aneurysm]. 975 Apr 50

A 56-year-old male with two mycotic aneurysms associated with infective endocarditis was treated by endovascular surgery before mitral valve replacement. Angiography revealed a ruptured proximal aneurysm and an unruptured distal aneurysm on the right middle cerebral artery. The ruptured aneurysm was successfully treated with an interlocking detachable coil, and patency of the parent artery was preserved. The unruptured distal aneurysm disappeared as a result of antibiotic therapy. Endovascular surgery of the mycotic aneurysm is less invasive and more effective than craniotomy under general anesthesia for patients with infective endocarditis.
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PMID:Cerebral mycotic aneurysm treated with endovascular occlusion--case report. 986 50

A 61-year-old man with chest pain and fever was referred to our hospital. The physical examination and electrocardiogram were unrevealing. Laboratory tests showed leukocytosis, and echocardiography showed mild pericardial effusion. The patient died soon after hospital admission. Necropsy revealed ruptured mycotic aneurysm of the right coronary artery in the absence of infective endocarditis. Thus, mycotic aneurysm of the coronary artery may occur without infective endocarditis and may be clinically manifested as pericarditis and leukocytosis.
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PMID:Cryptogenic mycotic aneurysm of the right coronary artery. 993 31

Infective endocarditis continues to attract the attention of many physicians. The authors present a case report of a 64 year old man with a history of infective endocarditis of a native aortic valve complicated by a perivalvular abscess, mycotic aneurysm of a sinus of valsalva and acquired aorta-right ventricular shunt.
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PMID:[Aortic peri-valvular abscess, mycotic aneurysm of Valsalva sinus, and fistula to the right ventricle in a context of acute infectious endocarditis]. 995 Oct 61


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