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Wang TH, Zhao JC, Huang B, Wang JR, Yuan D. Successful endovascular treatment with long-term antibiotic therapy for infectious pseudoaneurysm due to Klebsiella pneumoniae: A case report. World J Clin Cases 2020; 8:6529-6536. [PMID: 33392341 PMCID: PMC7760425 DOI: 10.12998/wjcc.v8.i24.6529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infectious common femoral artery pseudoaneurysm caused by Klebsiella pulmonary infection is a relatively infrequent entity but is potentially life and limb threatening. The management of infectious pseudoaneurysm remains controversial.
CASE SUMMARY We reported a 79-year-old man with previous Klebsiella pneumoniae pulmonary infection and multiple comorbidities who presented with a progressive pulsate mass at the right groin and with right lower limb pain. Computed tomography angiography showed a 6 cm × 6 cm × 9 cm pseudoaneurysm of the right common femoral artery accompanied by occlusion of the right superficial femoral artery and deep femoral artery. He underwent endovascular treatment (EVT) with stent–graft, and etiology of infectious pseudoaneurysm was confirmed. Then, 3-mo antibiotic therapy was given. One-year follow-up showed the stent–graft was patent and complete removal of surrounding hematoma.
CONCLUSION The femoral artery pseudoaneurysm can be caused by Klebsiella pneumoniae deriving from the pulmonary infection. Moreover, this unusual case highlights the use of EVT and prolonged antibiotic therapy for infectious pseudoaneurysm.
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Affiliation(s)
- Tie-Hao Wang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Ji-Chun Zhao
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Bin Huang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Jia-Rong Wang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Ding Yuan
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
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Fatal Rupture of Brachial Pseudoaneurysm in a Drug Abuser: Case Report and Review of the Literature. Am J Forensic Med Pathol 2019; 40:386-390. [PMID: 31305278 DOI: 10.1097/paf.0000000000000504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The injection of drugs of abuse causes many millions of deaths each year; deaths are mostly due to fatal overdose and the trauma and infection caused by repeated injections. The scientific literature widely reports cases of infected pseudoaneurysm in injecting drug abusers; however, most of these autopsy cases deal with the rupture of pseudoaneurysm of the femoral artery. We present fatal hemorrhagic shock in a heroin-cocaine abuser subsequent to rupture of pseudoaneurysm of the brachial artery; the man collapsed just before injecting himself with a dose of heroin-cocaine (speedball).
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Sunagawa K, Uchino Y, Ishimoto S, Nakamura S, Honma T, Nakanishi Y, Hatta Y, Miyazaki Y, Sakurai H, Hao H, Sugitani M. Mycotic pseudoaneurysm of a pulmonary artery branch caused by Cladosporium. Pathol Int 2017; 68:47-52. [PMID: 29193597 DOI: 10.1111/pin.12615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 11/04/2017] [Indexed: 11/28/2022]
Abstract
We report the case of a 53-year-old male with a history of acute myelogenous leukemia, who suffered the rupturing of a right-sided pulmonary artery pseudoaneurysm combined with pneumonia. He underwent a right-sided lower lobectomy. The resected lung tissue demonstrated a mycotic pseudoaneurysm of a pulmonary artery branch together with a filamentous fungal infection. Pseudoaneurysms are caused by the breaching of all layers of a blood vessel wall. The extravasated blood is trapped by the surrounding extravascular tissue or clots. Cladosporium was detected during a polymerase chain reaction-based analysis followed by DNA sequencing of formalin-fixed paraffin-embedded lung tissue samples. Although previous cases of pulmonary artery pseudoaneurysms caused by fungal infections, e.g., Candida or Aspergillus sp., have been reported, to the best of our knowledge this is the first case to involve cladosporiosis.
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Affiliation(s)
- Keishin Sunagawa
- Department of Pathology, Showa University, Shinagawa-ku, Tokyo, Japan.,Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.,Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Yoshihito Uchino
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shinichirou Ishimoto
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Taku Honma
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoko Nakanishi
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshihiro Hatta
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Sakurai
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hiroyuki Hao
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masahiko Sugitani
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
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Giuliano S, Guastalegname M, Russo A, Falcone M, Ravasio V, Rizzi M, Bassetti M, Viale P, Pasticci MB, Durante-Mangoni E, Venditti M. Candida endocarditis: systematic literature review from 1997 to 2014 and analysis of 29 cases from the Italian Study of Endocarditis. Expert Rev Anti Infect Ther 2017; 15:807-818. [PMID: 28903607 DOI: 10.1080/14787210.2017.1372749] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Candida Endocarditis (CE) is a deadly disease. It is of paramount importance to assess risk factors for acquisition of both Candida native (NVE) and prosthetic (PVE) valve endocarditis and relate clinical features and treatment strategies with the outcome of the disease. Areas covered: We searched the literature using the Pubmed database. Cases of CE from the Italian Study on Endocarditis (SEI) were also included. Overall, 140 cases of CE were analyzed. Patients with a history of abdominal surgery and antibiotic exposure had higher probability of developing NVE than PVE. In the PVE group, time to onset of CE was significantly lower for biological prosthesis compared to mechanical prosthesis. In the whole population, greater age and longer time to diagnosis were associated with increased likelihood of death. Patients with effective anti-biofilm treatment, patients who underwent cardiac surgery and patients who were administered chronic suppressive antifungal treatment showed increased survival. For PVE, moderate active anti-biofilm and highly active anti-biofilm treatment were associated with lower mortality. Expert commentary: Both NVE and PVE could be considered biofilm-related diseases, pathogenetically characterized by Candida intestinal translocation and initial transient candidemia. Cardiac surgery, EAB treatment and chronic suppressive therapy might be crucial in increasing patient survival.
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Affiliation(s)
- Simone Giuliano
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Maurizio Guastalegname
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Alessandro Russo
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Marco Falcone
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
| | - Veronica Ravasio
- b Infectious Diseases Unit , ASST Papa Giovanni XXIII , Bergamo , Italy
| | - Marco Rizzi
- b Infectious Diseases Unit , ASST Papa Giovanni XXIII , Bergamo , Italy
| | - Matteo Bassetti
- c Infectious Diseases Division , Santa Maria Misericordia University Hospital , Udine , Italy
| | - Pierluigi Viale
- d Infectious Diseases Unit, Department of Medical and Surgical Sciences , Alma Mater Studiorum University of Bologna , Bologna , Italy
| | | | - Emanuele Durante-Mangoni
- f Department of Clinical and Experimental Medicine , Università della Campania 'Luigi Vanvitelli', AORN dei Colli-Ospedale Monaldi , Naples , Italy
| | - Mario Venditti
- a Department of Public Health and Infectious Diseases , Policlinico Umberto I 'Sapienza' University of Rome , Rome , Italy
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