Mycotic aneurysms of the pulmonary artery

Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis - A case report and a review of the literature

INTRODUCTION

Mycotic aneurysms of the pulmonary arteries are very rare and have high mortality. Risk groups are intravenous drug users and patients with congenital heart disorders. The surgical approach varies due to a limited number of reported cases.

PRESENTATION OF CASE

We present a case of a mycotic aneurysm of the right pulmonary artery in a 56-year old man presenting with recurrent pneumonias, weight loss and hemoptysis.

DISCUSSION

There is often a diagnostic delay because of non-specific symptoms mimicking more common disorders. Treatment strategies include conservative management, surgery and endovascular treatment.

CONCLUSION

This report demonstrates a rare case of aneurysm of the pulmonary artery presenting with hemoptysis. For rapidly progressing proximal aneurysms of the pulmonary arteries, the midline surgical approach is recommended.

A rare case of left lung hypoplasia associated with congenital pulmonary artery aneurysm and ventricular septal defect

This report describes a 3-year-old boy who presented with hemoptysis and a history of congenital heart disease detected at the age of 3 months. Clinical and laboratory evaluation showed a large true congenital pulmonary artery aneurysm of the left main pulmonary artery occupying the entire left hemithorax and two small aneurysms in the right lung. In addition, a restricted ventricular septal defect was detected. It was evident on clinical and histologic grounds that the multiple aneurysms seen in this child stemmed from congenital weakness of the arterial wall in conjunction with increased pulmonary blood flow and elevated pulmonary artery pressure.

Aneurysm of the pulmonary trunk with patent arterial duct

We present a 14-year-old female with a massive aneurysm of the pulmonary trunk occurring secondary to bacterial endocarditis of the patent arterial duct. Echo Doppler imaging, magnetic resonance and angiography confirmed the diagnosis. On intermediate follow-up after surgical correction, the echo studies and cardiac catheterization disclosed no residual lesions. The patient is now asymptomatic.

Mycotic aneurysms of the pulmonary arteries in intravenous drug addicts. Report of three cases and review of the literature

During the postmortem study of pulmonary lesions in intravenous drug addicts, three patients were found to have bilateral multiple mycotic aneurysms of the peripheral pulmonary arteries in association with embolic pneumonia. Two of these patients had infective tricuspid endocarditis, and one had hemoptysis. This report draws attention to the occurrence of mycotic aneurysms in this unusual location and suggests that these pulmonary lesions may be more common than currently believed.

Verminous aneurysm caused by filaria

Aneurysms caused by atherosclerosis are relatively frequent, as a consequence of the high incidence of this degenerative disease of the arteries. Other types of aneurysm, for example, those of infectious etiology, are more uncommon. Bacterias and fungi are able to cause aneurysms in several parts of the arterial tree. Stengel et al (1943), in a review of world literature described 217 cases of mycotic aneurysms. The Stedman's Medical Dictionary refers to a special type of aneurysm observed in horses, caused by intra-vascular migration of a worm, the Strongylus vulgaris. It has been named verminous aneurysm and generally involves the mesenteric arteries. We haven't found in medical literature any similar observations refering to human cases. The purpose of this paper is to describe a case of aneurysm the etiology of which we have imputed to the filaria (Wuchereria bancrofti). This case was observed in Marcilio Dias Naval Hospital, Rio de Janeiro, Brazil.

Pulmonary and systemic aneurysms in a case of widespread arteritis

A patient in whom asthma preceded the development of multiple pulmonary and systemic artery aneurisms died after dissection of the aorta. At necropsy he was found to have widespread arteritis of unknown aetiology affecting many large and medium-sized pulmonary and systemic vessels as well as a few microscopic ones. Endarteritis obliterans was present in some of the vasa vasorum. The clinical and histopathological findings are discussed in relationship to other known causes of arteritis, and it is concluded that this condition has not previously been described.

Aneurysm of a pulmonary artery branch: an uncommon cause of a coin lesion

We report the case of a 26-year-old woman with ventricular septal defect associated with a typical coin lesion as shown on the chest roentgenogram. Selective angiography revealed the coin lesion to be caused by an aneurysm of a tertiary pulmonary arterial branch. In addition, two smaller aneurysms were noted. It is postulated on clinical and histologic grounds that the aneurysms were caused by congenital weakness of the pulmonary arterial wall in conjunction with increased pulmonary flow and slightly elevated pulmonary arterial pressure.