Mycotic aneurysms of the intracranial and peripheral circulation: A rare complication of bacterial endocarditis

Blood cultures were repeatedly sent in view of history of longstanding recurrent fever and clinical suspicion of bacterial endocarditis, but were negative each time however still a diagnosis of possible infective endocarditis could be made from Duke's minority criteria [1] as there was predispo...

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Published inAnnals of the Indian Academy of Neurology Vol. 17; no. 1; pp. 82 - 84
Main Authors Jain, Rajendra Singh, Mathur, Tarun, Srivastava, Trilochan, Jain, Rahul, Sannegowda, Raghavendra Bakki
Format Journal Article
LanguageEnglish
Published India Medknow Publications and Media Pvt. Ltd 01.01.2014
Medknow Publications & Media Pvt. Ltd
Medknow Publications & Media Pvt Ltd
Wolters Kluwer Medknow Publications
Subjects
Aneurysm, Infected
Aneurysms
Case studies
Complications and side effects
Drug therapy
Endocarditis, Bacterial
Fever
Images in Neurology
Medical imaging
Neurological research
Thrombosis
Veins & arteries
India
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Summary:Blood cultures were repeatedly sent in view of history of longstanding recurrent fever and clinical suspicion of bacterial endocarditis, but were negative each time however still a diagnosis of possible infective endocarditis could be made from Duke's minority criteria [1] as there was predisposing heart condition, presence of persistent fever, evidence of vascular phenomenon in the form of mycotic aneurysm and intracranial hemorrhage (as detailed in discussion) and immunological phenomenon in the form of glomerulonephritis. {Figure 3} After 1 month, he developed a pulsatile painful swellling in left elbow region and in view of clinical suspicion of arterial aneurysm, upper limb angiogram was carried out along with brain angiogram, which revealed large pseudoaneurysm arising from left brachial artery while in CT angio brain there was the paucity of flow in left middle cerebral artery distal branches with complete disappearance of previously visible left MCA aneurysm [Figure 4] suggestive of complete thrombosis of that aneurysm.
ISSN:0972-2327
1998-3549
DOI:10.4103/0972-2327.128560