Mycotic Renal Artery Aneurysm Presenting as Critical Limb Ischemia in Culture-Negative Endocarditis

• Published in: Case reports in surgery Vol. 2018; no. 2018; pp. 1 - 3
• Main Authors: Sorial, Ehab, Wu, Tiffany, Itoga, Nathan K., Ho, Vy Thuy, Garcia-Toca, Manuel
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2018; Hindawi; Hindawi Limited; Wiley
• Subjects: Abdomen; Amputation; Aneurysm; Aneurysms; Angiography; Antibiotics; Aortic valve; Cardiology; Case Report; Case reports; CAT scans; Creatinine; Diagnosis; Diagnostic imaging; Drug abuse; Echocardiography; Endocarditis; Femoral artery; Femur; Hematuria; Hypertension; Intravenous administration; Intravenous drug abuse; Ischemia; Kidney diseases; Knee; Medical imaging; Medical prognosis; Methicillin; Pain; Patients; Renal artery; Staphylococcus aureus; Staphylococcus infections; Substance abuse treatment; Surgery; Transplants & implants; Type 2 diabetes; Vascular diseases; Vascular surgery; Veins & arteries
• ISSN: 2090-6900; 2090-6919
• DOI: 10.1155/2018/7080813

Mycotic renal artery aneurysms are rare and can be difficult to diagnose. Classic symptoms such as hematuria, hypertension, or abdominal pain can be vague or nonexistent. We report a case of a 53-year-old woman with a history of intravenous drug abuse presenting with critical limb ischemia, in which CT angiography identified a mycotic renal aneurysm. This aneurysm tripled in size from 0.46 cm to 1.65 cm in a 3-week interval. Echocardiography demonstrated aortic valve vegetations leading to a diagnosis of culture-negative endocarditis. The patient underwent primary resection and repair of the aneurysm, aortic valve replacement, and left below-knee amputation after bilateral common iliac and left superficial femoral artery stenting. At 1-year follow-up, her serum creatinine is stable and repaired artery remains patent.