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Cardiac
Diagnosis
Aorta
Mycotic Aneurysm
Mycotic Aneurysm
Sanjeeva P. Kalva, MD, FSIR, FCIRSE; Hriday Shah, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Infectious aneurysm (more appropriate term)

              • Definitions

                • Aneurysm arising from infection of arterial wall, usually bacterial

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Echocardiographic Findings

                          • Angiographic Findings

                            • Nuclear Medicine Findings

                              • Imaging Recommendations

                                DIFFERENTIAL DIAGNOSIS

                                  PATHOLOGY

                                  • General Features

                                    • Staging, Grading, & Classification

                                      • Gross Pathologic & Surgical Features

                                        • Microscopic Features

                                          CLINICAL ISSUES

                                          • Presentation

                                            • Demographics

                                              • Natural History & Prognosis

                                                • Treatment

                                                  DIAGNOSTIC CHECKLIST

                                                  • Consider

                                                    • Image Interpretation Pearls

                                                      • Reporting Tips

                                                        Selected References

                                                        1. Haidar GM et al: "In situ" endografting in the treatment of arterial and graft infections. J Vasc Surg. 65(6):1824-9, 2017
                                                        2. Sörelius K et al: Endovascular treatment of mycotic aortic aneurysms: a paradigm shift. J Cardiovasc Surg (Torino). 58(6):870-4, 2017
                                                        3. Deipolyi AR et al: Imaging findings, diagnosis, and clinical outcomes in patients with mycotic aneurysms: single center experience. Clin Imaging. 40(3):512-6, 2016
                                                        4. Murphy DJ et al: Cross-sectional imaging of aortic infections. Insights Imaging. 7(6):801-18, 2016
                                                        5. Uchida N et al: In situ replacement for mycotic aneurysms on the thoracic and abdominal aorta using rifampicin-bonded grafting and omental pedicle grafting. Ann Thorac Surg. 93(2):438-42, 2012
                                                        6. Iida H et al: Bacteremia causes mycotic aneurysm of the aortic arch in 110 days. Ann Thorac Surg. 83(5):1874-6, 2007
                                                        7. Taylor CF et al: Treatment options for primary infected aorta. Ann Vasc Surg. 21(2):225-7, 2007
                                                        8. Froeschl M et al: Ruptured mycotic pseudoaneurysm of the thoracic aorta. Cardiovasc Pathol. 15(2):116-8, 2006
                                                        9. Kerzmann A et al: Infected abdominal aortic aneurysm treated by in situ replacement with cryopreserved arterial homograft. Acta Chir Belg. 106(4):447-9, 2006
                                                        10. Lee KH et al: Stent-graft treatment of infected aortic and arterial aneurysms. J Endovasc Ther. 13(3):338-45, 2006
                                                        11. Palanichamy N et al: Mycotic pseudo-aneurysm of the ascending thoracic aorta after cardiac transplantation. J Heart Lung Transplant. 25(6):730-3, 2006
                                                        12. Ting AC et al: Endovascular stent graft repair for infected thoracic aortic pseudoaneurysms--a durable option? J Vasc Surg. 44(4):701-5, 2006
                                                        13. Gonzalez-Fajardo JA et al: Endovascular repair in the presence of aortic infection. Ann Vasc Surg. 19(1):94-8, 2005
                                                        14. Ting AC et al: Surgical treatment of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta. Am J Surg. 189(2):150-4, 2005
                                                        15. Malouf JF et al: Mycotic aneurysms of the thoracic aorta: a diagnostic challenge. Am J Med. 115(6):489-96, 2003
                                                        16. Cina CS et al: Ruptured mycotic thoracoabdominal aortic aneurysms: a report of three cases and a systematic review. J Vasc Surg. 33(4):861-7, 2001
                                                        17. Locati P et al: Salmonella mycotic aneurysms: traditional and "alternative" surgical repair with arterial homograft. Minerva Cardioangiol. 47(1-2):31-7, 1999
                                                        18. Long R et al: Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest. 115(2):522-31, 1999
                                                        19. Fichelle JM et al: Infected infrarenal aortic aneurysms: when is in situ reconstruction safe? J Vasc Surg. 17(4):635-45, 1993
                                                        Related Anatomy
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                                                        Related Differential Diagnoses
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                                                        References
                                                        Tables

                                                        Tables

                                                        KEY FACTS

                                                        • Terminology

                                                          • Imaging

                                                            • Top Differential Diagnoses

                                                              • Pathology

                                                                • Clinical Issues

                                                                  • Diagnostic Checklist

                                                                    TERMINOLOGY

                                                                    • Synonyms

                                                                      • Infectious aneurysm (more appropriate term)

                                                                    • Definitions

                                                                      • Aneurysm arising from infection of arterial wall, usually bacterial

                                                                    IMAGING

                                                                    • General Features

                                                                      • Radiographic Findings

                                                                        • CT Findings

                                                                          • MR Findings

                                                                            • Ultrasonographic Findings

                                                                              • Echocardiographic Findings

                                                                                • Angiographic Findings

                                                                                  • Nuclear Medicine Findings

                                                                                    • Imaging Recommendations

                                                                                      DIFFERENTIAL DIAGNOSIS

                                                                                        PATHOLOGY

                                                                                        • General Features

                                                                                          • Staging, Grading, & Classification

                                                                                            • Gross Pathologic & Surgical Features

                                                                                              • Microscopic Features

                                                                                                CLINICAL ISSUES

                                                                                                • Presentation

                                                                                                  • Demographics

                                                                                                    • Natural History & Prognosis

                                                                                                      • Treatment

                                                                                                        DIAGNOSTIC CHECKLIST

                                                                                                        • Consider

                                                                                                          • Image Interpretation Pearls

                                                                                                            • Reporting Tips

                                                                                                              Selected References

                                                                                                              1. Haidar GM et al: "In situ" endografting in the treatment of arterial and graft infections. J Vasc Surg. 65(6):1824-9, 2017
                                                                                                              2. Sörelius K et al: Endovascular treatment of mycotic aortic aneurysms: a paradigm shift. J Cardiovasc Surg (Torino). 58(6):870-4, 2017
                                                                                                              3. Deipolyi AR et al: Imaging findings, diagnosis, and clinical outcomes in patients with mycotic aneurysms: single center experience. Clin Imaging. 40(3):512-6, 2016
                                                                                                              4. Murphy DJ et al: Cross-sectional imaging of aortic infections. Insights Imaging. 7(6):801-18, 2016
                                                                                                              5. Uchida N et al: In situ replacement for mycotic aneurysms on the thoracic and abdominal aorta using rifampicin-bonded grafting and omental pedicle grafting. Ann Thorac Surg. 93(2):438-42, 2012
                                                                                                              6. Iida H et al: Bacteremia causes mycotic aneurysm of the aortic arch in 110 days. Ann Thorac Surg. 83(5):1874-6, 2007
                                                                                                              7. Taylor CF et al: Treatment options for primary infected aorta. Ann Vasc Surg. 21(2):225-7, 2007
                                                                                                              8. Froeschl M et al: Ruptured mycotic pseudoaneurysm of the thoracic aorta. Cardiovasc Pathol. 15(2):116-8, 2006
                                                                                                              9. Kerzmann A et al: Infected abdominal aortic aneurysm treated by in situ replacement with cryopreserved arterial homograft. Acta Chir Belg. 106(4):447-9, 2006
                                                                                                              10. Lee KH et al: Stent-graft treatment of infected aortic and arterial aneurysms. J Endovasc Ther. 13(3):338-45, 2006
                                                                                                              11. Palanichamy N et al: Mycotic pseudo-aneurysm of the ascending thoracic aorta after cardiac transplantation. J Heart Lung Transplant. 25(6):730-3, 2006
                                                                                                              12. Ting AC et al: Endovascular stent graft repair for infected thoracic aortic pseudoaneurysms--a durable option? J Vasc Surg. 44(4):701-5, 2006
                                                                                                              13. Gonzalez-Fajardo JA et al: Endovascular repair in the presence of aortic infection. Ann Vasc Surg. 19(1):94-8, 2005
                                                                                                              14. Ting AC et al: Surgical treatment of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta. Am J Surg. 189(2):150-4, 2005
                                                                                                              15. Malouf JF et al: Mycotic aneurysms of the thoracic aorta: a diagnostic challenge. Am J Med. 115(6):489-96, 2003
                                                                                                              16. Cina CS et al: Ruptured mycotic thoracoabdominal aortic aneurysms: a report of three cases and a systematic review. J Vasc Surg. 33(4):861-7, 2001
                                                                                                              17. Locati P et al: Salmonella mycotic aneurysms: traditional and "alternative" surgical repair with arterial homograft. Minerva Cardioangiol. 47(1-2):31-7, 1999
                                                                                                              18. Long R et al: Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest. 115(2):522-31, 1999
                                                                                                              19. Fichelle JM et al: Infected infrarenal aortic aneurysms: when is in situ reconstruction safe? J Vasc Surg. 17(4):635-45, 1993