Mycotic aneurysms in parenteral drug abusers: An Indian experience
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Four femoral and one brachial mycotic aneurysms were identified in five mainliners who took various narcotic injections for personal gratification. All presented with contained rupture of a pseudoaneurysm with bleed into surrounding tissues; inflammation and celluitis with loss of distal pulses; and varying degrees of ischaemia. All patients underwent emergency surgery consisting of excision of the aneurysm and debridement of the wound which was left open to granulate. Two patients had revascularisation in the same setting by an extra-anatomic bypass using a prosthetic graft. In the other three patients only ligation was performed. The state of the local tissues, degree of ischaemia and general condition of the patient governed the decision in favour of vascular reconstruction versus simple ligation. The organism most commonly identified from the arterial wall and clot culture was Staphylococcus aureus. No fungi were isolated. All patients survived without serious ischaemic complications. None needed amputation. Appreciation of this increasingly important cause of mycotic aneurysm prompts judicious decision making and surgery towards saving limb and life.
KeywordsDrug Addict Mycotic Aneurysm Infected Aneurysm Left Common Iliac Artery Parenteral Drug Abuse
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- 1.Reddy DJ, Ernst CB. Infected aneurysms.In Rutherford RB, ed.Vascular Surgery, 3rd edition; Philadelphia WB Saunders Company, 1989: 983–96.Google Scholar
- 3.Revel STR Jr. Primary mycotic aneurysms.Ann Intern Med 1945;22: 431–40.Google Scholar
- 4.Stengel A, Wolferth CC. Mycotic (bacterial) aneurysms of intravascular origin.Arch Intern Med 1923;31:527–54.Google Scholar
- 6.Mokoena T, Robbs JV. Surgical management mycotic aneurysms.South Afr J Surg 1991;29: 103–7.Google Scholar
- 9.Hankins JR, Yeager GH. Primary mycotic aneurysm.Surgery 1956;40: 477–546.Google Scholar
- 10.O’Conner TW, Lord RA, Tracy GD. Treatment of mycotic aneurysms.Med J Aust 1972;2: 1161–4.Google Scholar
- 12.Feldmen J, Berguer R. Management of an infected aneurysm of the groin secondary to drug abuse.Surg Gynecol Obstet 1983;157: 519–22.Google Scholar