Ver el código de «Mycotic aneurysm»

==Background==
[[File:Mycotic pulmonary artery aneurysm, ruptured (4860663580).jpg|thumb|A mycotic aneurysm of the pulmonary artery complicating tricuspid infectious endocarditis. The aneurysm has ruptured producing massive hemorrhage.]]
*Arterial vessel wall dilation due to bacterial, fungal, or viral infection <ref>Majeed H, Ahmad F. Mycotic Aneurysm. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560736/</ref>
*Incidence is rare
** 1-5% of aortic aneurysms <ref>Parkhurst GF, Dekcer JP. Bacterial aortitis and mycotic aneurysm of the aorta: a report of twelve cases. Am J Pathol 1955; 31:821–835</ref> <ref>Sommerville RL, Allen EV, Edwards JE. Bland and infected arteriosclerotic abdominal aortic aneurysms: a clinicopathologic study. Medicine (Baltimore) 1959; 38:207–221 </ref> and intracranial aneurysms <ref>Kannoth S, Thomas SV. Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management. Neurocrit Care 2009; 11:120–129</ref><ref>Nakahara I, Taha MM, Higashi T, et al. Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol 2006; 66:405–409; discussion, 409–410</ref>
** Seen in up to 2% of infective endocarditis cases <ref>González I, Sarriá C, López J, et al. Symptomatic peripheral mycotic aneurysms due to infective endocarditis: a contemporary profile. Medicine (Baltimore) 2014; 93:42–52</ref>

===Risk Factors===
* Immunocompromised
* [[IV drug use]]
* Infective [[endocarditis]]
* Status post invasive intravascular procedures

==Clinical Features==
===Signs/Symptoms===
*[[Fever]]
*Pulsatile mass
*Localized inflammation at arterial access site (if s/p intravascular intervention)
*Symptoms may vary by location affected (e.g. [[stroke]]-like symptoms with intracranial aneurysm, [[abdominal pain]] with mycotic [[AAA]])

==Differential Diagnosis==

==Evaluation==
[[File:Aneurisma micótico de la arteria ilíaca izquierda.jpg|thumb|Mycotic aneurysm of the left iliac artery seen on angiography.]]
===Labs===
*CBC
*ESR/CRP
*CMP
*Urinalysis
*Blood cultures
*Coagulation studies
*Type and Cross

===Imaging===
*CT angiography (Sensitivity 0.82 (95% CI, 0.77–0.87), specificity 0.93 (95% CI, 0.89–0.95)) <ref>Wang TKM, Griffin B, Cremer P, et al. Diagnostic Utility of CT and MRI for Mycotic Aneurysms: A Meta-Analysis. AJR Am J Roentgenol. 2020;215(5):1257-1266. doi:10.2214/AJR.19.22722</ref>
*MR angiography (Sensitivity 0.79 (95% CI, 0.61–0.91), specificity 0.89 (95% CI, 0.81–0.95)) <ref>Wang TKM, Griffin B, Cremer P, et al. Diagnostic Utility of CT and MRI for Mycotic Aneurysms: A Meta-Analysis. AJR Am J Roentgenol. 2020;215(5):1257-1266. doi:10.2214/AJR.19.22722</ref>

==Management==
*Emergent vascular surgery consultation
*Broad spectrum IV antibiotics with gram positive, gram negative, and anaerobic coverage
*Bilateral large-bore peripheral IVs
*Definitive care with surgical debridement and endovascular vs open repair

==Disposition==
*Admission to OR or ICU in consultation with vascular surgery

==See Also==
*[[Abdominal Aortic Aneurysm]]

==External Links==

==References==
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