These particular aneurysms are otherwise known as infected aneurysms. The aneurysm develops by either direct invasion of the wall of the aorta with a microorganism or through the bloodstream. The latter occurs when there is an infection in another area of the body, i.e. heart valve, and the bacteria travels through the bloodstream and burrows into wall of the aorta at another site. The bacteria causes weakening of the wall of the aorta leading to the formation of an aneurysm. These aneurysms need immediate surgical intervention due to the high rupture risk if left untreated. Antibiotic therapy needs to be started prior to surgery and continued for numerous weeks after repair of the aneurysm. Some patients need life-long antibiotic therapy depending on the location of the aneurysm, extent of infection, the type of bacteria or fungus and if foreign material is involved.
Symptoms:
- pain
- fever
- chills
- difficulty in swallowing
- sweats
- no energy
Signs:
- heart murmur
- fever
- weakness
- hoarseness (change in voice pitch)
- painful,pulsatile mass (lump)
Diagnosis:
- blood test, elevated white blood count
- elevated erythrocyte sedimentation count (ESR)
- elevated c-reactive protein (CRP)
- positive blood cultures
- echocardiogram
- CTA or MRA
Treatment: (depends on patient’s condition)
- Antibiotics
- Surgery
- TEVAR in high risk patients
- life-long antibiotics
- surveillance with CT or MRI for recurrence of infection.