title: Mycotic pseudoaneurysm of the brachiocephalic artery.
abstract: A 73-year-old woman with a history of hypertension and hyperlipidemia presented with a sharp pain ranging from the right shoulder to the upper limb. She had suffered a sharp pain at rest accompanied by general fatigue and nausea for about ten months prior to admission. Her white blood cell count was 12,800/microl, and her serum C-reactive protein was 17.5 mg/dl. A chest computed tomography scan revealed an aneurysmal change of the origin of the brachiocephalic artery. Pseudoaneurysm due to infection and aortic dissection was considered as a preoperative diagnosis. A total arch replacement was performed under cardiopulmonary bypass, deep hypothermia, and selective cerebral perfusion. Postoperatively, a bacteriologic culture of the contents of the aneurysm revealed Staphylococcus aureus. Perioperative administration of antibiotics was effective and the postoperative course was uneventful.
authors.affiliation: Department of Cardiovascular Surgery, Miyazaki Prefectural Nobeoka Hospital, Kiyotake, Miyazaki 889-1692, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ninomiya
authors.forename: Masachika
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayase
authors.forename: Kouji
authors.initials: K
authors.lastname: Furukawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Onitsuka
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000382:microbiology* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000601:surgery*