Benramdane Hicham, Ziani Hamid, Nasri Siham, Kamaoui Imane, Skiker Imane
Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco.
Department of Radiology, Mohammed VI University Hospital Mohammed I University Oujda Morocco.
Radiol Case Rep. 2024 Nov 30;20(2):1156-1159. doi: 10.1016/j.radcr.2024.10.154. eCollection 2025 Feb.
Mycotic aneurysms are a rare but potentially life-threatening complication of infections, particularly those involving the spine. Spondylodiscitis, a bacterial or fungal infection of the intervertebral disc, is a known risk factor for the development of mycotic aneurysms. Early diagnosis and prompt treatment are crucial for improving patient outcomes. We report the case of a 79-year-old patient with a history of diabetes admitted for chronic back pain refractory to medical treatment. A cervico-thoraco-abdomino-pelvic CT scan showed infectious spondylodiscitis at the lumbar level complicated by a mycotic aneurysm of the infrarenal abdominal aorta. This case highlights the diagnostic challenges associated with mycotic aneurysms, particularly when they arise from a contiguous infectious focus. Imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), play a pivotal role in identifying these aneurysms and assessing their extent. The patient underwent surgical management of the spondylodiscitis and the mycotic aneurysm. A stent was placed to reinforce the weakened aortic wall and prevent rupture. Postoperative management included long-term antibiotic therapy to eradicate the infection. The patient experienced a favorable outcome, with resolution of symptoms and improved quality of life.
真菌性动脉瘤是感染的一种罕见但可能危及生命的并发症,尤其是涉及脊柱的感染。脊椎椎间盘炎,即椎间盘的细菌或真菌感染,是真菌性动脉瘤发生发展的已知危险因素。早期诊断和及时治疗对于改善患者预后至关重要。我们报告一例79岁有糖尿病史的患者,因药物治疗无效的慢性背痛入院。颈胸腹部盆腔CT扫描显示腰椎水平存在感染性脊椎椎间盘炎,并伴有肾下腹主动脉真菌性动脉瘤。该病例突出了与真菌性动脉瘤相关的诊断挑战,尤其是当它们源于相邻感染灶时。诸如计算机断层扫描(CT)和磁共振成像(MRI)等成像方式在识别这些动脉瘤及其范围评估中起着关键作用。患者接受了脊椎椎间盘炎和真菌性动脉瘤的手术治疗。放置了一个支架以加固薄弱的主动脉壁并防止破裂。术后管理包括长期抗生素治疗以根除感染。患者预后良好,症状缓解,生活质量改善。