title: A mycotic forearm pseudoaneurym as an unusual complication of infective endocarditis.
abstract: BACKGROUND
  Mycotic pseudoaneurysms are an infrequent complication of infective endocarditis; most cases are secondary to arterial trauma. The commonest site involved are the intracranial arteries, followed by the abdominal aorta and then the peripheral vessels.
  
  
  METHODS
  We report a case of a 36-year-old man, admitted in our institution for a subarachnoid haemorrhage, who presented with fever of unknown origin during his stay in the neurocritical care unit and whom was diagnosed infective endocarditis due to Meticilin Sensible Staphylococcus Aureus. Almost two weeks after antibiotic therapy was instituted, he presented a large, growing, pulsatile mass of the left forearm. A giant pseudoaneurysm arising from the radial artery was detected with ultrasound and surgical intervention was carried out. A large laceration of the radial artery was detected and an interposition of a vein graft was performed.
  
  
  CONCLUSIONS
  Forearm mycotic pseudoaneurysms are rare. A high index of suspicion is needed and they should always be borne in mind in the differential diagnosis of an extremity pain, swelling or motor-sensorial deficit after infective endocarditis.
authors.affiliation: Departmento de Angiologia e Cirurgia Vascular do Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Gonçalo M
authors.initials: GM
authors.lastname: Rodrigues
authors.forename: Carlos Oliveira
authors.initials: CO
authors.lastname: Amaral
authors.forename: Hugo Dias
authors.initials: HD
authors.lastname: Valentim
authors.forename: Anita
authors.initials: A
authors.lastname: Quintas
authors.forename: Maria Emília
authors.initials: ME
authors.lastname: Ferreira
authors.forename: João Albuquerque
authors.initials: JA
authors.lastname: Castro
authors.forename: Luís Mota
authors.initials: LM
authors.lastname: Capitão
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000150:complications*; D005542:Forearm; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000150:complications*