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© Therese Couderc, Marc Lecuit
Publication : Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Fungal internal carotid artery aneurysms: successful embolization of an Aspergillus-associated case and review

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 15 Dec 2007

Hot A, Mazighi M, Lecuit M, Poirée S, Viard JP, Loulergue P, Suarez F, Dupont B, Merland JJ, Lortholary O

Link to Pubmed [PMID] – 18190310

Clin. Infect. Dis. 2007 Dec;45(12):e156-61

BACKGROUND: Fungal aneurysms of the carotid artery are rare. We report here a case of Aspergillus fumigatus invasive sphenoidal sinusitis complicated by carotid artery aneurysms in a severely neutropenic patient who was successfully treated with a combination of antifungal therapy and embolization of all aneurysms.

METHODS AND RESULTS: Carotid aneurysms were suspected when severe epistaxis occurred during follow-up for sinusitis. MRI angiograph and cerebral angiograph revealed 5 aneurysms involving the right intracavernous carotid artery. Coil endovascular embolization was successfully used for the first time in this context, and the patient is alive 2 years later. We also reviewed the literature and identified 10 cases of fungal carotid artery aneurysms. Aspergillus species was the most common fungal organism. All patients were immunocompromised and had to be treated surgically.

CONCLUSIONS: Internal carotid arterial involvement is a rare but life-threatening complication of invasive fungal sinusitis. Fungal aneurysms should be diagnosed early, so that the embolization procedure can be performed before the occurrence of severe bleeding.

http://www.ncbi.nlm.nih.gov/pubmed/18190310