Tuckson W, Anderson B B
J Natl Med Assoc. 1985 Feb;77(2):99-102.
Mycotic aneurysms are caused by microorganisms in the vessel wall. The most commonly reported cause of mycotic aneurysms today is intravenous drug abuse. The diagnosis should be entertained whenever a mass is encountered over a major vessel in an intravenous drug abuser. The clinical findings often include a tender, pulsatile mass overlying an artery. The single best diagnostic test is the arteriogram. The treatment is based on early exploration with debridement of all necrotic and infected tissue, effective drainage, and appropriate antibiotic coverage.Restoration of vascular continuity is desirable when possible, and necessary when the viability of the extremity requires it. When reconstitution of the vessel is contemplated, the following principles are advocated (1) resection of all nonviable arterial wall, (2) use of monofilament synthetic suture, (3) achievement of a tension-free anastomosis with or without the use of autogenous grafts, (4) effective local drainage, and (5) appropriate antibiotic coverage.
真菌性动脉瘤是由血管壁中的微生物引起的。如今，静脉药物滥用是真菌性动脉瘤最常见的报道病因。对于静脉药物滥用者，只要在大血管上发现肿块，就应考虑诊断。临床发现通常包括动脉上方有压痛、搏动性肿块。最佳的诊断检查是动脉造影。治疗基于早期探查，清除所有坏死和感染组织，有效引流，并给予适当的抗生素覆盖。尽可能恢复血管连续性，当肢体的存活需要时则是必要的。当考虑血管重建时，提倡以下原则：（1）切除所有无活力的动脉壁；（2）使用单丝合成缝线；（3）无论是否使用自体移植物，实现无张力吻合；（4）有效局部引流；（5）适当的抗生素覆盖。
