Cerebral Mycotic Aneurysm and Infective Endocarditis: A Case Study

Abstract

Mycotic aneurysms resulting from endocarditis are uncommon, and patients having aneurysms in multiple locations are rare. We report on a case of a patient having both infrapopliteal and cerebral mycotic aneurysms as a result of endocarditis. A patient was referred to the vascular lab for a lower extremity venous duplex, which incidentally demonstrated an infrapopliteal aneurysm of the right tibio-peroneal trunk. Computed tomography (CT) demonstrated two separate aneurysms: one at the origin of the anterior tibial artery and another involving the peroneal artery. The anterior tibial artery aneurysm was treated surgically. A transesophageal echocardiogram was performed on the patient and identified vegetation on the prosthetic aortic valve. The patient was then transferred to another facility for replacement of the prosthetic aortic valve. The patient suffered a cerebrovascular accident (CVA) postoperatively and subsequently had two cerebral mycotic aneurysms identified and treated.