Mycotic Aneurysm of Internal Carotid Artery Secondary to Livestock-associated Methicillin-resistant Staphylococcus Aureus Clonal Complex CC398
| Autor: | Laura Escolà-Vergé, Mayli Lung, Angel Xavier Tenezaca-Sari, Daniel Gil-Sala, Juan José González-López, Sergi Bellmunt-Montoya |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment General Medicine Mycotic aneurysm medicine.disease_cause Methicillin-resistant Staphylococcus aureus Surgery Dental extraction Positron emission tomography medicine.artery cardiovascular system medicine cardiovascular diseases Leukocytosis Autologous Vein Graft Internal carotid artery medicine.symptom Cardiology and Cardiovascular Medicine business Computed tomography angiography |
| Zdroj: | Annals of Vascular Surgery. 78:379.e7-379.e10 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.06.031 |
| Popis: | The aim of this article is to present a case of mycotic aneurysm of internal carotid artery secondary to livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) treated with resection and common-to-internal carotid artery bypass with autologous vein graft in a male pig farmer. A 69-year-old man, pig farmer, with recent dental extraction was admitted with a right cervical pulsatile mass, dysphonia, pain, leukocytosis and elevated C-reactive protein (CRP). Ultrasonography (US) and computed tomography angiography (CTA) showed a 3.9 × 4.5 cm mycotic aneurysm of right internal carotid artery with hypermetabolic uptake in positron emission tomography (PET) scan. Resection of the mycotic aneurysm and a common-to-internal carotid artery bypass with major saphenous vein graft were performed. LA-MRSA clonal complex (CC) 398 was detected in intraoperative samples and antibiotic therapy was changed according to antibiogram. Patient was discharged at the seventh postoperative day and received antibiotic therapy for 6 weeks. US 12 months later showed patency of the bypass without collections. Mycotic aneurysms of internal carotid artery are very infrequent. MRSA isolation is rare, and to the best of our knowledge this is the first case caused by multi-drug resistant LA-MRSA CC398. The treatment includes mycotic aneurysm resection and reconstruction with venous graft bypass plus intensive antibiotic therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|