Mycotic aneurysms (MA) are an uncommon complication of infectious endocarditis. Septic emboli are thought to be the precipitating event in their development, but the evidence for this is sparse. We present three cases in which septic embolic occlusion preceded MA development at the occlusion site, suggesting that documented angiographic emboli in patients with infectious endocarditis and bacteremia constitute a risk factor for MA formation. Two adult patients with a history of intravenous drug use and one child with congenital heart disease are described. They were all diagnosed with infectious endocarditis and developed neurological symptoms during their hospital course. Initial catheter-based cerebral angiograms demonstrated vascular occlusions, which were followed by the development of MA at the same sites within 1 month. Septic emboli, documented on cerebral angiogram, in patients with infectious endocarditis may precede the appearance of MA. Patients with angiographic occlusions in the setting of endocarditis warrant close follow-up.

译文

霉菌性动脉瘤 (MA) 是感染性心内膜炎的罕见并发症。化脓性栓子被认为是其发展中的诱因,但证据很少。我们介绍了3例脓毒症栓塞闭塞先于MA在闭塞部位发展的病例,这表明感染性心内膜炎和菌血症患者的血管造影栓塞是MA形成的危险因素。描述了两名有静脉吸毒史的成年患者和一名患有先天性心脏病的儿童。他们都被诊断出患有感染性心内膜炎,并在住院期间出现神经系统症状。最初的基于导管的脑血管造影显示血管闭塞,随后在1个月内在相同部位发生MA。感染性心内膜炎患者在脑血管造影上记录的败血性栓子可能先于MA出现。心内膜炎背景下血管造影闭塞的患者需要密切随访。

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