Vascular Surgery Department, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia
Infectious Diseases Department, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia.
BMJ Case Rep. 2021 Nov 23;14(11):e246389. doi: 10.1136/bcr-2021-246389.
Mycotic aneurysms are rare and if left untreated, can have devastating outcomes. In this case, a 72-year-old man presented to hospital with fevers, night sweats and abdominal pain. A CT scan revealed the development an infrarenal pseudoaneurysm over the course of 8 weeks, increasing from 2.8 cm to a 3.1 cm. The aneurysm was not present on a CT scan performed 6 months earlier. The patient underwent an emergency endovascular repair of the aortic aneurysm (EVAR) and was placed on broad-spectrum antibiotics. Intra-aortic blood cultures aspirated adjacent to the aneurysm and tissue biopsy confirmed tuberculosis bovis as the cause of the mycotic aneurysm. The patient had been treated with intravesical BCG for transitional cell carcinoma of the bladder several months prior. The patient was treated with an extended course of antituberculosis medication. He recovered well and was back to his baseline function within weeks.
真菌性动脉瘤罕见，如果不治疗，可能会产生毁灭性的后果。本例中，一名 72 岁男性因发热、盗汗和腹痛就诊于医院。CT 扫描显示在 8 周内出现了肾下假性动脉瘤，从 2.8 厘米增大至 3.1 厘米。该动脉瘤在 6 个月前进行的 CT 扫描中并未显示。患者接受了紧急腹主动脉瘤腔内修复术（EVAR），并使用了广谱抗生素。在紧邻动脉瘤处抽取了主动脉内血液培养物和组织活检，证实分枝杆菌性真菌性动脉瘤的病因是牛分枝杆菌。患者在几个月前因膀胱移行细胞癌接受了膀胱内卡介苗治疗。患者接受了延长的抗结核药物治疗。他在数周内恢复良好，恢复到基线功能。
