Intrathoracic tracheal obstruction caused by a carotid mycotic aneurysm in a patient with deep neck infection--a case report.
Upper airway obstruction secondary to a carotid mycotic aneurysm has not been previously reported. We describe a patient with a mycotic aneurysm associated with a deep neck infection and presenting with acute tracheal obstruction. Recognition of this condition is important to avoid inadvertent rupture of the aneurysm in the course of diagnostic aspiration or surgical drainage. Physical findings, including a pulsating mass and an arterial bruit, in addition to appropriate imaging studies, may be helpful in suggesting the diagnosis. In particular, both neck and chest contrast-enhanced computed tomography scans may give important clues to the presence of a vascular lesion. In a patient with an infected neck mass and tracheal compression, a common carotid mycotic aneurysm should be considered in the differential diagnosis.
Chest Division, Department of Medicine, Mackay Memorial Hospital, Main Branch Hospital, Taipei, Taiwan, ROC.
Shih-Yi
SY
Lee
Kun-Ming
KM
Wu
Pei-Jan
PJ
Chen
Chin-Yin
CY
Sheu
Chiu-Ping
CP
Kuo
Tao-Yeuan
TY
Wang
Chien-Liang
CL
Wu
D000038:Abscess / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000785:Aneurysm, Infected / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017536:Carotid Artery, Common; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009333:Neck; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods
D000900:Anti-Bacterial Agents