Juan M Remirez1, Yasmin Sabet1, Marshall Baca2, Alberto Maud3, Salvador Cruz-Flores3, Gustavo J Rodriguez3, Debabrata Mukherjee4, Aamer Abbas4. 1. Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA. 2. Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA. 3. Department of Neurology, Texas Tech University Health Sciences Center, El Paso, TX, USA. 4. Department of Internal Medicine, Division of Cardiology, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Abstract
BACKGROUND: Mycotic aneurysms are a complication of infective endocarditis. Infection of left ventricular assist devices (LVADs) may lead to bacteremia and fever causing complications similar to those seen in patients with prosthetic valve endocarditis. Intracranial mycotic aneurysms are rare, and their presence is signaled by the development of subarachnoid hemorrhage in the setting of bacteremia and aneurysms located distal to the circle of Willis. CASE PRESENTATION: We present the case of a patient with a LVAD presenting with headache who is found to have an intracranial mycotic aneurysm through computed tomography angiography of the head. The patient was successfully treated with endovascular intervention. CONCLUSION: In patients with LVADs, mycotic aneurysms have been reported, however not intracranially. To the best of our knowledge, this is the first intracranial mycotic aneurysm secondary to LVAD infection that was successfully treated with endovascular repair. Intracranial mycotic aneurysms associated with LVADs are a rare phenomenon. The diagnosis of mycotic aneurysms requires a high index of suspicion in patients who present with bacteremia with or without headache and other neurological symptoms. DISCLOSURE: None.
BACKGROUND: Mycotic aneurysms are a complication of infective endocarditis. Infection of left ventricular assist devices (LVADs) may lead to bacteremia and fever causing complications similar to those seen in patients with prosthetic valve endocarditis. Intracranial mycotic aneurysms are rare, and their presence is signaled by the development of subarachnoid hemorrhage in the setting of bacteremia and aneurysms located distal to the circle of Willis. CASE PRESENTATION: We present the case of a patient with a LVAD presenting with headache who is found to have an intracranial mycotic aneurysm through computed tomography angiography of the head. The patient was successfully treated with endovascular intervention. CONCLUSION: In patients with LVADs, mycotic aneurysms have been reported, however not intracranially. To the best of our knowledge, this is the first intracranial mycotic aneurysm secondary to LVAD infection that was successfully treated with endovascular repair. Intracranial mycotic aneurysms associated with LVADs are a rare phenomenon. The diagnosis of mycotic aneurysms requires a high index of suspicion in patients who present with bacteremia with or without headache and other neurological symptoms. DISCLOSURE: None.
Entities:
Keywords:
Mycotic aneurysm; bacteremia; left ventricular assist device (LVAD)
Authors: Andrew F Ducruet; Zachary L Hickman; Brad E Zacharia; Reshma Narula; Bartosz T Grobelny; Justin Gorski; E Sander Connolly Journal: Neurosurg Rev Date: 2009-10-16 Impact factor: 3.042
Authors: James K Kirklin; David C Naftel; Robert L Kormos; Lynne W Stevenson; Francis D Pagani; Marissa A Miller; J T Baldwin; J Timothy Baldwin; James B Young Journal: J Heart Lung Transplant Date: 2013-02 Impact factor: 10.247
Authors: Tanu Garg; Shyam Panchal; Tariq Nisar; David McCane; Jason Lee; Ken Chyuan Ling; Barry Trachtenberg; Arvind Bhimaraj; David Chiu; Rajan Gadhia Journal: Cureus Date: 2021-05-25