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非伤寒型分枝杆菌所致腘动脉霉菌性动脉瘤合并深部静脉血栓形成病例

Case of non-typhoidal spp mycotic popliteal artery aneurysm with concurrent deep vein thrombosis.

作者信息

Sangiorgio Michael, Choo Shi Zhou, Gavaghan Daniel, McDougall Katherine

机构信息

Department of General Medicine, Barwon Health, Geelong, Victoria, Australia

Department of General Medicine, Barwon Health, Geelong, Victoria, Australia.

出版信息

BMJ Case Rep. 2023 Aug 14;16(8):e255052. doi: 10.1136/bcr-2023-255052.

Abstract

Mycotic aneurysms are a well-recognised complication of non-typhoidal bacteraemia; the risk is increased in patients with atherosclerotic disease. The infrarenal abdominal aorta is the most common site of infection; lower extremity aneurysms are uncommon.Here we present the case of a patient with cardiovascular disease and recurrent non-typhoidal bacteraemia, who developed a left-sided popliteal artery mycotic aneurysm with secondary popliteal vein thrombosis. The aneurysm was diagnosed upon rupture, and managed with surgical excision and bypass graft. He went on to have a complete recovery.This case illustrates the importance of clinician awareness of popliteal artery endovascular infection as a rare but significant complication of non-typhoidal bacteraemia, which should be considered in cases with cardiovascular risk factors, recurrent or persistent bacteraemia, and lower limb deep vein thrombosis.

摘要

真菌性动脉瘤是非伤寒菌血症公认的一种并发症;动脉粥样硬化疾病患者发生真菌性动脉瘤的风险会增加。肾下腹主动脉是最常见的感染部位;下肢动脉瘤并不常见。在此,我们报告一例患有心血管疾病且反复发生非伤寒菌血症的患者,该患者发生了左侧腘动脉真菌性动脉瘤并继发腘静脉血栓形成。动脉瘤在破裂时被诊断出来,并通过手术切除和旁路移植进行治疗。他最终完全康复。该病例说明了临床医生认识到腘动脉血管内感染作为非伤寒菌血症一种罕见但重要的并发症的重要性,在伴有心血管危险因素、反复或持续菌血症以及下肢深静脉血栓形成的病例中应考虑到这一点。

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