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Mycotic femoral aneurysm.

Abstract
After several weeks of fever and chills, a 31-year-old logger developed pain in his right thigh. Upon examination a tender, pulsating upper thigh mass was found with a long loud bruit arising from it. Severe aortic insufficiency was present; however, blood cultures were negative. An angiogram, captured blood with contrast spewing from the profunda femoral artery to fill a 5 x 10 cm sac. A false aneurysm was diagnosed and resected; numerous gram positive cocci were present in cut sections, but cultures from the cavity grew the gram negative bacteria Salmonella and Alcaligenes. After one month of intravenous ampicillin the aortic valve was replaced after being destroyed by endocarditis. Ampicillin was continued and recovery was uneventful. Mycotic aneurysms are commonly caused by Salmonella (10%), which was second only to Staphylococcus (30%). The femoral artery accounts for 38% of all mycotic aneurysms. They typically present with a pulsatile mass (52%), bruit (50%), and fever (48%). This diagnosis can be supported by leukocytosis (64-71%), positive blood cultures (50-85%), and a history of arterial trauma (51%) (injection drug use, intravascular procedure, or trauma) or endocarditis (10%).
AuthorsRichard Scott Wilson, Kenneth R Bennett
JournalJournal of the Mississippi State Medical Association (J Miss State Med Assoc) Vol. 48 Issue 5 Pg. 131-2 (May 2007) ISSN: 0026-6396 [Print] United States
PMID17941249 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Aneurysm, Infected (diagnosis, diagnostic imaging, surgery)
  • Femoral Artery (pathology)
  • Humans
  • Male
  • Radiography

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