Jorgensen Matthew S, Oldenburg W Andrew, Murray Peter M
Division of Vascular Surgery, Jacksonville, FL.
Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL.
J Hand Surg Am. 2019 Oct;44(10):905.e1-905.e4. doi: 10.1016/j.jhsa.2018.12.001. Epub 2019 Feb 4.
Mycotic aneurysms, especially those of the upper extremity, are rarely reported in literature. These aneurysms are caused by bacterial endocarditis and, therefore, are more commonly seen in patients who are in an immunocompromised state, including those requiring bacillus Calmette-Guérin (BCG) therapy for bladder cancer. Owing to the inevitable rupture of mycotic aneurysms, the standard treatment is surgical repair with appropriate secondary antibiotics. We present a unique case of a mycotic ulnar artery aneurysm following BCG therapy and repetitive hand trauma in a patient with bladder cancer that was successfully repaired with microsurgical techniques and secondary antibiotics.
真菌性动脉瘤,尤其是上肢的真菌性动脉瘤,在文献中鲜有报道。这些动脉瘤由细菌性心内膜炎引起,因此更常见于免疫功能低下的患者,包括那些因膀胱癌需要卡介苗(BCG)治疗的患者。由于真菌性动脉瘤不可避免会破裂,标准治疗方法是进行手术修复并使用适当的二线抗生素。我们报告了一例独特的病例,一名膀胱癌患者在接受卡介苗治疗并反复手部创伤后出现尺动脉真菌性动脉瘤,通过显微外科技术和二线抗生素成功修复。