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a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism

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動脈瘤(りゅう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/27 11:30:05」(JST)

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A mycotic aneurysm is an aneurysm arising from bacterial infection of the arterial wall. It can be a common complication of the hematogenous spread of bacterial infection.^[1]

William Osler first used the term "mycotic aneurysm" in 1885 to describe a mushroom-shaped aneurysm in a patient with subacute bacterial endocarditis. This may create considerable confusion, since "mycotic" is typically used to define fungal infections. However, mycotic aneurysm is still used for all extracardiac or intracardiac aneurysms caused by infections, except for syphilitic aortitis.^[2]

The term "infected aneurysm," proposed by Jarrett and associates^[3] is more appropriate, since few infections involve fungi.^[4] According to some authors, a more accurate term might have been endovascular infection or infective vasculitis, because mycotic aneurysms are not due to a fungal organism.^[5]

Mycotic aneurysms account for 2.6% of aortic aneurysms.^[2] For the clinician, early diagnosis is the cornerstone of effective treatment. Without medical or surgical management, catastrophic hemorrhage or uncontrolled sepsis may occur. However, symptomatology is frequently nonspecific during the early stages, so a high index of suspicion is required to make the diagnosis.^[4]

Intracranial mycotic aneurysms (ICMAs) complicate about 2% to 3% of infective endocarditis (IE) cases, although as many as 15% to 29% of patients with IE have neurologic symptoms.^[5]

References[edit]

^ Yang CY, Liu KL, Lee CW et-al. Mycotic aortic aneurysm presenting initially as an aortic intramural air pocket. AJR Am J Roentgenol. 2005;185 (2): 463-5. AJR Am J Roentgenol (citation) - Pubmed citation
^ ^a ^b Bayer AS, Scheld WM. Endocarditis and intravascular infections. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill Livingstone; 2000:888-892.
^ Jarrett F, Darling RC, Mundth ED, Austen WG. Experience with infected aneurysms of the abdominal aorta. Arch Surg. 1975;110:1281-1286.
^ ^a ^b Mycotic (Infected) Aneurysm Caused by Streptococcus pneumoniae. Khosrow Afsari, et al. Infect Med. 2001;18(6) http://www.medscape.com/viewarticle/410168
^ ^a ^b http://www.gundersenhealth.org/upload/docs/Research/MedJournal/Vol6No1Endocarditis.pdf

UpToDate Contents

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1. 感染性（真菌）大動脈瘤の概要 overview of infected mycotic arterial aneurysm
2. 感染性心内膜炎の合併症および転帰 complications and outcome of infective endocarditis
3. 頭蓋外頸動脈瘤 extracranial carotid artery aneurysm
4. 胸部大動脈瘤の疫学、危険因子、病因、および自然史 epidemiology risk factors pathogenesis and natural history of thoracic aortic aneurysm
5. 感染性心内膜炎患者における抗凝固療法 antithrombotic therapy in patients with infective endocarditis

English Journal

Operation for an infected thoracoabdominal aneurysm in a patient previously treated with an axillobifemoral bypass for an infected abdominal aortic prosthesis: a case report.

Dregelid E.SourceDepartment of Vascular Surgery, Haukeland University Hospital, Bergen, Norway.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.Ann Thorac Cardiovasc Surg.2012 Feb 20;18(1):75-8. Epub 2011 Sep 29.
High operative mortality of infected thoracoabdominal aortic aneurysms (ITAA) is partly attributable to ischemic injury during aortic clamping. A case is presented of an 88-year old man who was admitted with imminent rupture of an ITAA. Axillobifemoral bypass grafting had been performed after remova
PMID 21959197

Mycotic pseudoaneurysms complicating renal transplantation: a case series and review of literature.

Leonardou P, Gioldasi S, Zavos G, Pappas P.AbstractABSTRACT: INTRODUCTION: Kidney transplantation can be complicated by infection and subsequent development of mycotic aneurysm, endangering the survival of the graft and the patient. Management of this condition in five cases is discussed, accompanied by a review of the relevant literature. Case presentations: Five patients, three men 42-, 67- and 57-years-old and two women 55- and 21-years-old (mean age of 48 years), all Caucasians, developed a mycotic aneurysm in the region of the anastomosis between renal graft artery and iliac axes. Four patients presented with systemic fever and iliac fossa pain and one presented with hemorrhagic shock. Morphologic investigation by color doppler ultrasonography revealed a pseudoaneurysm at the anastomotic site. A combination of antibiotic therapy, surgery and interventional procedures was required as all kidney transplants had to be removed. No recurrence was recorded during the follow-up period. CONCLUSIONS: A high index of suspicion is required for the timely diagnosis of a mycotic aneurysm; aggressive treatment with cover stents and/or surgical excision is necessary in order to prevent potentially fatal complications.
Journal of medical case reports.J Med Case Reports.2012 Feb 14;6(1):59. [Epub ahead of print]
ABSTRACT: INTRODUCTION: Kidney transplantation can be complicated by infection and subsequent development of mycotic aneurysm, endangering the survival of the graft and the patient. Management of this condition in five cases is discussed, accompanied by a review of the relevant literature. Case pre
PMID 22333365

Japanese Journal

症例肺炎球菌による感染性大動脈瘤の1例および文献的考察

中村由紀子,齋藤崇,西尾久明 [他]
感染症学雑誌 85(5), 515-519, 2011-09
NAID 40019011257

感染性心内膜炎に伴う脳梗塞

田口芳治,田中耕太郎
循環器内科 69(5), 508-516, 2011-05
NAID 40018880501

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リンク元	「感染性動脈瘤」「真菌性動脈瘤」「細菌性動脈瘤」「infected aneurysm」「infective aneurysm」
関連記事	「mycotic」