Learning objectives
To briefly review the most important concepts around micotic aneurysms and graphically describe some possible and severe complications caused by them in the human spine.
Background
Micotic aneurysms represent a 0.06-2.6% of all aneurysms. They are relevant because of their high mortality, caused by sepsis or rupture.
They can be formed by parietal weakening due to infection (eg: septic plunger) or by overinfection of a pre-existing one, usually located in the infrarenal aorta. The two main etiologic agents are Salmonella Tiphy and Staphylococcus Aureus, which cause vascular trauma.
The clinical manifestations may be fever of unknown origin, abdominal pain and mass or low back pain.
The diagnosis comes from the hand...
Findings and procedure details
1st CLINICAL CASE:
- 73 years old male
- Bladder neoplasm surgically intervened
- Nonspecific abdominal pain
US
On ultrasound an infrarenal aortic aneurysm with a significant thickening of the left lateral wall is identified (Fig. 1).
1st CT
The study is completed with a CT (Fig. 2), observing: Infarrenal abdominal aortic aneurysm with a maximum diameter of 4.7 cm and 9 cm long. Surrounding the left lateral side of the aneurysm, a heterogeneous tissue with soft tissue density is identified, which reaches a thickness...
Conclusion
Micotic aneurysms can lead to osteomyelitis and/or spondylodiscitis. Severe complications, both of them, because of their possible indolent and progressive clinical evolution.
Personal information and conflict of interest
P. Sanz Bellon; Santander/ES - nothing to disclose A. Pérez Del Barrio; Santander/ES - nothing to disclose P. Menéndez Fernández-Miranda; Santander/ES - nothing to disclose J. Azcona Saenz; Santander/ES - nothing to disclose D. Herrán de la Gala; Santander/ES - nothing to disclose E. Yllera Contreras; Burgos/ES - nothing to disclose E. M. Alonso Fernandez; Santander/ES - nothing to disclose
References
Kaufman JA, Lee MJ. Vascular and interventional radiology, the requisites. Mosby Inc. (2004) ISBN:0815143699. Read it at Google Books - Find it at Amazon
Dähnert W. Radiology review manual. Lippincott Williams & Wilkins. (2003) ISBN:0781738954. Read it at Google Books - Find it at Amazon
Kumar V, Abbas AK, Fausto N et-al. Robbins and Cotran pathologic basis of disease. W B Saunders Co. (2005) ISBN:0721601871. Read it at Google Books - Find it at Amazon
Yang CY, Liu KL, Lee CW et-al. Mycotic aortic aneurysm...
