[The management by medical treatment of an intracranial mycotic aneurysm in a patient with infectious endocarditis with negative blood cultures and hypertrophic myocardiopathy].
A case of intracranial mycotic aneurysm due to culture-negative infective endocarditis involving a patient with hypertrophic cardiomyopathy is reported. The patient, a 22-year-old woman with no history of known prior disease, had fever, headache and focal neurologic symptoms 3 days before admission. An echocardiogram performed after admission disclosed an obstructive hypertrophic cardiomyopathy and a gross vegetation on septal leaflet of mitral valve. Cerebral angiography revealed a mycotic aneurysm involving a peripheral branch of the left middle cerebral artery. Causal agent was not identified, and empiric treatment with penicillin G and streptomycin achieved medical cure and disappearance of the aneurysm 2 weeks later. Four months after endocarditis had been cured, the patient was electively operated because of progression of mitral regurgitation. Six months later, she is asymptomatic.
Anguita
M
M
Servicio de Cardiología, Hospital Reina Sofía, Córdoba.
Romo
E
E
Viñals
M
M
Ostos
J
J
Bueno
G
G
Vivancos
R
R
Franco
M
M
Suárez de Lezo
J
J
Vallés
F
F
D000328:Adult; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D001419:Bacteria / Q000302:isolation & purification; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008943:Mitral Valve / Q000382:microbiology; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D010400:Penicillin G / Q000008:administration & dosage; D013307:Streptomycin / Q000008:administration & dosage
D010400:Penicillin G; D013307:Streptomycin
Curación con tratamiento médico de un aneurisma micótico intracraneal en un paciente con endocarditis infecciosa con hemocultivos negativos y miocardiopatía hipertrófica.