TITLE:
Peptostreptococcus Mycotic Pseudo-Aneurysm
AUTHORS:
Geoffrey Horlait, Pierre Bulp
KEYWORDS:
Microbiology, Anaerobic Pathogens, Mycotic Aneurysm, Peptostreptococcus
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.6 No.3,
March
27,
2017
ABSTRACT: Mycotic pseudo-aneurysm is a rare and potentially fatal sequela of bacteraemia. The injury results in a localized, irreversible dilatation due to destruction of the blood vessel wall by infection, usually with an aerobic bacterium. Anaerobic bacteria are uncommon. We report an unusual case of a 72-year-old Caucasian man who presented with a rapidly progressive mycotic pseudoaneurysm of the right subclavian artery due to an anaerobic Gram-positive coccus Peptoniphilus asaccharolyticus. Despite optimal treatment, combining antibiotics and surgery, mycotic pseudo-aneurysm has a poor prognosis. When surgery is not possible, antibiotics alone with or without the placement of an endovascular stent have been proposed but in such cases, mortality is very significant. Despite the availability of non-invasive imaging techniques, a strong clinical suspicion is essential for early diagnosis of a mycotic aneurysm. Clinicians must be aware of these important aspects of management.