title: Fungal internal carotid artery aneurysms: successful embolization of an Aspergillus-associated case and review.
abstract: BACKGROUND
  Fungal aneurysms of the carotid artery are rare. We report here a case of Aspergillus fumigatus invasive sphenoidal sinusitis complicated by carotid artery aneurysms in a severely neutropenic patient who was successfully treated with a combination of antifungal therapy and embolization of all aneurysms.
  
  
  RESULTS
  Carotid aneurysms were suspected when severe epistaxis occurred during follow-up for sinusitis. MRI angiograph and cerebral angiograph revealed 5 aneurysms involving the right intracavernous carotid artery. Coil endovascular embolization was successfully used for the first time in this context, and the patient is alive 2 years later. We also reviewed the literature and identified 10 cases of fungal carotid artery aneurysms. Aspergillus species was the most common fungal organism. All patients were immunocompromised and had to be treated surgically.
  
  
  CONCLUSIONS
  Internal carotid arterial involvement is a rare but life-threatening complication of invasive fungal sinusitis. Fungal aneurysms should be diagnosed early, so that the embolization procedure can be performed before the occurrence of severe bleeding.
authors.affiliation: Services des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Hot
authors.forename: Mikaël
authors.initials: M
authors.lastname: Mazighi
authors.forename: Marc
authors.initials: M
authors.lastname: Lecuit
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poirée
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Viard
authors.forename: Pierre
authors.initials: P
authors.lastname: Loulergue
authors.forename: Felipe
authors.initials: F
authors.lastname: Suarez
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dupont
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Merland
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D001228:Aspergillosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D001232:Aspergillus fumigatus; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D002343:Carotid Artery, Internal / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged