Mycotic aneurysm

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Mycotic Aneurysm

An infected aneurysm is a bulge in an artery caused by bacteria damaging the wall of the artery. It often starts when bacteria spread through the bloodstream.

Key points:
- Intracranial mycotic aneurysms occur in about 2–3% of people with infective endocarditis, though many endocarditis patients have neurological symptoms.
- The aorta is commonly affected by bacteria such as Staphylococcus and Salmonella; anaerobic bacteria like Bacteroides and Clostridium can also cause aortic mycotic aneurysms.
- Aortic involvement can also happen with tuberculosis, usually through nearby spread or blood-borne spread, but this is rare.
- Mycotic abdominal aortic aneurysm is rare and life-threatening. Because it’s rare, there aren’t many large studies to guide treatment, though a management protocol has been published.
- The term was first used by William Osler in 1885 for a mushroom-shaped aneurysm in endocarditis. It can be confusing because “mycotic” suggests fungus, but most infections are bacterial. Some experts prefer the term “infected aneurysm” or “endovascular infection.”
- Mycotic aneurysms account for about 2.6% of aortic aneurysms.
- Early diagnosis is crucial. Without treatment, rupture or severe infection can occur. Early symptoms are often non-specific, so doctors must maintain a high level of suspicion.