Kreidy Raghid, Hatem Joe
Vascular Surgery Division, Saint George Hospital University Medical Center, Beirut & Faculty of Medicine, University of Balamand, Lebanon.
J Med Liban. 2006 Jan-Mar;54(1):50-3.
Since antibiotics have been widely used in the treatment of bacterial endocarditis, mycotic aneurysms caused by septic emboli have become extremely rare. We report the case of a 66-year-old male patient who presented mycotic aneurysm of the right tibioperoneal trunk two weeks after aortic and mitral valve replacement due to Enterococcus fecalis endocarditis. The clinical presentation simulated thrombophlebitis of the deep veins of right calf. A pulsating mass was diagnosed clinically and duplex ultrasound confirmed the diagnosis of a mycotic aneurysm of the tibioperoneal trunk. Surgical treatment included the closure of the orifice of the aneurysm and excision of the aneurysmal sac. Arterial reconstruction was not required. Postoperative course was uneventful. No complication was observed at long-term follow-up. This observation represents the seventh case reported in the literature of mycotic aneurysm at this localization.
由于抗生素已广泛用于治疗细菌性心内膜炎，由感染性栓子引起的真菌性动脉瘤已极为罕见。我们报告一例66岁男性患者，因粪肠球菌心内膜炎行主动脉瓣和二尖瓣置换术后两周出现右胫腓干真菌性动脉瘤。临床表现类似右小腿深静脉血栓性静脉炎。临床诊断为搏动性肿块，双功超声证实为胫腓干真菌性动脉瘤。手术治疗包括封闭动脉瘤开口和切除动脉瘤囊。无需进行动脉重建。术后病程顺利。长期随访未观察到并发症。该病例是文献报道的此部位真菌性动脉瘤的第七例。
