Zheng Shuwei, Lee Cheng Chuan
Department of Infectious Diseases, Singapore General Hospital, Singapore.
Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Singapore.
Eur J Case Rep Intern Med. 2018 Feb 22;5(2):000766. doi: 10.12890/2017_000766. eCollection 2018.
We describe a patient with a mycotic aneurysm. A 91-year-old man presented with recurrent episodes of bacteraemia 2 months apart. During the second presentation, he underwent magnetic resonance imaging of the left lower limb that revealed rupture of the popliteal artery with a popliteal fossa collection. This was aspirated and cultures grew . He underwent endovascular stenting and received a prolonged course of antibiotics. Popliteal artery mycotic aneurysm should be considered as a differential in patients presenting with unilateral painful leg swelling and bacteraemia from microorganisms with a propensity for endovascular infections.
Our case illustrates a rare and unusual entity of ruptured popliteal mycotic aneurysm in an otherwise common scenario of recurrent nontyphoidal salmonellosis.In patients with recurrent bacteraemia, clinicians often perform computed tomography scans to look for extraintestinal sites of involvement; however, this frequently misses any peripherally sited aneurysms, which often do not manifest with any early clinical symptoms.
我们描述了一名患有真菌性动脉瘤的患者。一名91岁男性，每隔2个月出现反复菌血症发作。在第二次就诊时，他接受了左下肢磁共振成像检查，结果显示腘动脉破裂并伴有腘窝积液。对积液进行了抽吸，培养物生长出[具体微生物名称未给出]。他接受了血管内支架置入术，并接受了长时间的抗生素治疗。对于出现单侧腿部疼痛肿胀和菌血症且微生物有血管内感染倾向的患者，应将腘动脉真菌性动脉瘤视为鉴别诊断之一。
我们的病例说明了在复发性非伤寒沙门菌感染这一常见情况下，腘动脉真菌性动脉瘤破裂这一罕见且不寻常的情况。在复发性菌血症患者中，临床医生经常进行计算机断层扫描以寻找肠外受累部位；然而，这常常会遗漏任何外周部位的动脉瘤，这些动脉瘤通常不会表现出任何早期临床症状。
