Mycotic aortic aneurysm in a patient with Tolosa-Hunt syndrome.
Mycotic aneurysms have been associated with many clinical conditions. A tender pulsatile abdominal mass in association with fever, chills, and unrelenting back pain is suggestive of a leaking mycotic aneurysm. However, the extracranial manifestations of Tolosa-Hunt syndrome (THS) may mimic several of these symptoms. We report the case of a woman who was successfully treated with high-dose steroids for THS. Two months later, she was admitted to another hospital with rigors and unremitting back and abdominal pain. CT-guided aspiration of an L5-S1 paravertebral mass was done. The aspirate and blood cultures grew Staphylococcus aureus. Intravenous antibiotics and analgesics were administered with good relief. A month after discharge from that hospital, she was admitted to our hospital with classic signs and symptoms of a leaking mycotic aneurysm. She was treated surgically and has remained asymptomatic for 21 months. Tolosa-Hunt syndrome associated with mycotic aortic aneurysms has not been previously reported.
Best
I M
IM
Department of Surgery, Morehouse School of Medicine, Atlanta, GA 30310-1495, USA.
Bumpers
H L
HL
D015746:Abdominal Pain / Q000209:etiology; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001027:Aortography; D001416:Back Pain / Q000209:etiology; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008875:Middle Aged; D015641:Radiography, Interventional; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013211:Staphylococcus aureus; D013256:Steroids; D020333:Tolosa-Hunt Syndrome / Q000150:complications* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D013256:Steroids