An aspergillotic aneurysm of the internal carotid artery following allogeneic bone marrow transplantation: successful management with catheter coil embolization and long-term antifungal agents.
We report a case of a mycotic aneurysm of the internal carotid artery and cerebral hemorrhagic infarction resulting from Aspergillus middle ear infection in a patient with severe aplastic anemia who received unrelated bone marrow transplantation. Although a mycotic aneurysm is a rare complication, and most often fatal, the patient was successfully treated with catheter coil embolization of the internal carotid artery and long-term systemic antifungal therapy. This case emphasizes the need for the rapid diagnosis of potential fungal involvement of the vascular system and suggests the necessity for aggressive treatment, such as with the modality illustrated in this case.
Watanabe
T
T
Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan. twatanab@tokushima-med.jrc.or.jp
Okada
T
T
Okada
C
C
Onishi
T
T
Watanabe
H
H
Okamoto
Y
Y
Kitamura
Y
Y
Manabe
S
S
Matsubara
S
S
Kageji
T
T
Iwai
A
A
D000293:Adolescent; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology*; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000382:microbiology*; D002343:Carotid Artery, Internal / Q000382:microbiology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000382:microbiology*; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome
D000935:Antifungal Agents