Deep femoral artery pseudoaneurysm due to brucellosis

Ankara University, Engüri, Ankara, Turkey
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine (Impact Factor: 1.54). 01/2002; 20(12):1353-6.
Source: PubMed


Brucellosis is an infection characterized by nonspecific manifestations and usually involves the reticuloendothelial and musculoskeletal systems.1 Endocarditis and aneurysm formations are uncommon sequelae of the disease.2,3 In this report we present imaging findings of a patient with brucellosis in whom cardiovascular system involvement was predominant during the course of the disease.

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Available from: Evren Ustuner, Feb 01, 2014
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    ABSTRACT: Brucellosis is still a public health problem, particularly in developing countries. After the primary infection subsides, a chronic stage characterized by nonspecific manifestations can develop, during which it may not be possible to isolate Brucella organisms and agglutination test titers may or may not be high. We present the case of a 49-year-old man who had only nonspecific symptoms and a 2-month history of a pulsatile painful swelling in his right popliteal region. He had no history of trauma or surgery in that region, but he did ingest unpasteurized milk products. The patient's agglutination test titers were high, and Brucella melitensis was isolated from a bone marrow culture. Color Doppler sonography, T2-weighted MRI, and digital subtraction angiography were performed. Treatment with ultrasound-guided compression of the pseudoaneurysm failed because of high blood flow in its neck. Aneurysmectomy was undertaken, and the excised material was consistent with that from a mycotic pseudoaneurysm. Although both MRI and angiography provided useful information, the color Doppler sonography findings were characteristic of a pseudoaneurysm in the popliteal artery, and only that modality could detect the flow dynamics within the pseudoaneurysm.
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    ABSTRACT: Reports have noted aneurysmal dilatation of arteries in association with brucellosis, but involvement of intracranial vessels has not been documented to date. Sixty-one year old female patient who had been diagnosed with brucellosis 14 months earlier presented with symptoms of subarachnoid hemorrhage (SAH). Due to deterioration of the patient's clinical condition in spite of a two-drug antibiotic regimen, she was treated surgically and made a full recovery. It is important to identify this association promptly, as there are clinical implications for optimal management. The article also discusses the timing and duration of antibiotic therapy, indications for and considerations regarding surgery, and the use of other treatment modalities.
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