Mycotic aneurysm is a focal dilation of an infected arterial wall. This uncommon disease follows an aggressive and unpredictable clinical course with significant mortality, and presents unique diagnostic and therapeutic challenges. This review discusses the pathogenesis, diagnosis, and therapeutic management of mycotic aneurysms.
Historical Perspective Virchow first described a saccular outpoutching along an arterial wall corresponding to an embolic source in 1847 [1]. Mycotic aneurysms were initially considered a physical change secondary to mechanical pressure of emboli against the artery wall [2]. Infectious etiology was first hypothesized by Goodhart in 1877 [3]. The term ‘mycotic’ originates from Osler’s Gulstonian Lectures in 1885 [4] in which he associated aortic aneurysms resembling a fungus growth with a severe or “malignant” form of endocarditis and coined the term “mycotic aneurysms.” The term “mycotic” is a misnomer suggesting fungal infection, though it was originally intended to refer to all microorganisms [5]. Osler established a clear connection between endocarditis and its bacterial origin (“micrococci”) through histology using bacterial Gram staining, which at the time was novel in medical practice. He defined the mycotic process in the setting of endocarditis as the transference of microbes from the growth of the valves to distant parts. In 1887, Langton and Bowlby corroborated Osler’s findings with observations of numerous bacteria derived from the
the mitral valve 16 months ago and a Streptococcus mutans infection of the aortic valve 1 month ago.
Solitaire AB stent is sometimes used in the coiling of small intracranial aneurysms that have ruptured. With the advances in Neuroradiology techniques, the diagnosis of small aneurysms has been improving. According to “Jifang Zhang, Donghai Wang and Xingang” (2015) in a study titled “Solitaire AB stent-assisted coiling embolization of the treatment of ruptured very small intracranial aneurysms” (page 1) a study was performed at the Qilu
Throughout this essay, I’ve mentioned the word recovery numerous time. As Miss New Jersey it is a community that I would like to embrace, with over 23 million Americans in recovery today. These individuals are always going to struggle with addiction, but they work daily to replace destructive habits with healthy new ones, in the attempt to mainstream sobriety. I will represent this community as a Recovery advocate promoting institutions such as recovery centers and recovery high schools, and provide New Jersians in recovery with the tools to sustain long-term recovery. We need to support those, in recovery so they can do so “out loud”, society should not discriminate against a community that is working daily to better their lives, in the attempt
The aorta is the largest artery in the body and is the blood vessel that carries oxygen-rich blood away from the heart to all parts of the body. It widens and balloons the portion of an artery due to weakness in the wall of the blood vessel. A thoracic aortic aneurysm occurs in the part of the body's largest artery (the aorta) that passes through the chest. Depending on its location and size, it may rupture or dissect (tear), causing life-threatening internal bleeding. When detected in time, a thoracic aortic aneurysm can often be repaired with surgery or other less invasive techniques.
2. Zak, Radovan, ed. Growth of the Heart in Health and Disease. Raven Pr, 1984.
Brain aneurysms are caused by weak blood vessels that balloon and fill with blood which can fatally rupture. Once an aneurysm has ruptured, emergency surgery is needed to prevent the patient from suffering a subarachnoid hemorrhage, a fatal type of stroke. The insertion of a detachable embolic coil can prevent rupturing of aneurysms and the need for emergency surgery. A technical study was conducted which used an experimental model constructed in the necks of swine to simulate a specific type of brain aneurysm (1). A combination of stents and Guglielmi Detachable Coils were then inserted to inhibit the fatal bleeding into the brain. This research concluded that the Guglielmi Detachable embolic coil is a high impact device because it can
The dual court system in the United States consists of a federal court system and a state court system. The judicial branch is responsible for deciding the meaning of laws, determining how to apply them to real situations, and whether a law breaks the rules of the constitution.
The two most significant weakness related to the lack of specificity in etiological origin of the endocarditis, and an expanded discussion in relevance of results. The researchers explained that due to gathering their data from hospitals there was often a lack in specificity of microorganism identification in the codes submitted. More importantly, the researchers largely discussed the limitations in their study, rather than discussing the uses and significance of the article. While it is good to identify possible sources of error, the researchers overly focused on this, decreasing the confidence for readers in their
Necropsy studies of patients with right-sided infective endocarditis and of opiate addicts have shown that vegetation was ten times more common in the tricuspid valve than in the pulmonary valve. The involved valves were nearly always anatomically normal before the onset of the cardiac infection.the survival of patients with congenital heart disease has increased the number and age of the population susceptible to infective endocarditis. Formerly, the patients most susceptible to infective endocarditis were those with tetralogy of Fallot, patent ductus arteriosus and ventricular septal defect. Congenital and acquired valve deformities play an important role in the pathogenesis of the infection and are responsible for the increase of infective endocarditis in adults [3]. Vegetations usually develop on the low-pressure side of the defect with endocardial trauma, and downstream from the site of the lesions.In patients with patent ductus arteriosus, the vegetations first develop at the pulmonary end of
The main source for pumping blood through every single artery in the human body is the aorta. The aorta arises from the left ventricle of the heart and extends through the entire abdomen where it then bifurcates into the common iliac arteries. Over time, the arterial walls become weak and widen. As the pressure of blood pumping continues through the aorta, the weakened area starts to have an outpouching known as an aneurysm. “An aneurysm is an abnormal widening of an artery with an increase of greater than 1.5 times the normal diameter” (Medifocus, 2014, p. 19). The normal size of an aneurysm ranges from 1.4 cm to 3.0 cm. A diameter greater than 3 cm is considered to be an abnormal
“It’s not stress that kills us, it is our reaction to it.” That is a famed quote from Hans Selye, a famous Hungarian endocrinologist, that relates to moments when a life is in a physician’s hands. One wrong move of a doctor and a patient could die. Learning to overcome fears and concentrate on the task at hand is the most needed skill for a surgeon, a brain surgeon to be exact. Focusing on the central nervous system I can fix the abnormalities and diseases of the brain. One of the highest pressure surgeries neurosurgeons perform are the clipping of aneurysms.
Weaknesses in blood vessel walls may develop an abnormal widening. This “ballooning” is called an aneurysm. Some defects in arteries are congenital, others develop without a clear reason at various stages of life. Surgeons have repaired aneurysms in the brain, lower extremities, intestines, the heart
Coronary artery infection is brought on by the steady development of plaque (made of fat, cholesterol, and different substances) within dividers of the coronary supply routes. These arteries supply oxygen-rich blood to the heart. After some time, the plaque stores develop sufficiently huge to limit the arteries inside channels, diminishing blood stream to the heart muscle. On the off chance that the plaque gets to be precarious and breaks, blood coagulation can shape at the crack site and piece blood stream, bringing about a heart
Septicemia can lead to venous thrombosis especially when the blood work-up reveals anerorobic organism. There have been a recent reported case which suggests that septicemia could have led to OVT after blood cultures from samples taken from the patient were positive for F. necrophorum. Antibiotics have resulted in reduction in the incidence of Lemierre's syndrome over the past 50 years, but it is said to have increased recently because of the increased prescription of NSAIDS without suitable antibiotic
An AAA (abdominal aortic aneurysm) is defined as enlargement of at least 3 cm of the abdominal aorta. The majority of abdominal aortic aneurysms begins below the renal arteries and ends above the iliac arteries. The exact cause of (AAAs) is unknown. However, it is thought to be due to a degenerative process of the abdominal aorta caused by atherosclerosis. Artherosclerosis represents a response to vessel wall injury caused by inflammation, genetically regulated defects in collagen and fibrillin, increased protease activity within the arterial wall, and mechanical factors (Stoelting p. 143).