Cerebral mycotic aneurysms are rare complications of infective endocarditis, occurring in approximately 2% - 3% of cases, often asymptomatic and underdiagnosed. This report describes the case of an 80-year-old female with infective endocarditis caused by Enterococcus faecalis, who developed a cerebral mycotic aneurysm complicated by rupture, leading to a fatal outcome. Despite appropriate antibiotic treatment and clinical support, the progression was unfavorable, highlighting the severity of this complication. The case underscores the importance of early diagnosis and multidisciplinary management in high-risk patients.
Morita, N., Miura, K., Harada, M., et al. (2021) Mycotic Cerebral Aneurysms in Infective Endocarditis: Pathophysiology, Diagnosis, and Treatment. Journal of Stroke and Cerebrovascular Diseases, 30, Article ID: 105708.
[3]
Ducruet, A.F., Hickman, Z.L., Zacharia, B.E., et al. (2010) Intracranial Infectious Aneurysms: A Comprehensive Review. Neurosurgical Review, 33, 37-46. https://doi.org/10.1007/s10143-009-0233-1
[4]
Peters, P.J., Harrison, T. and Lennox, J. (2019) Aneurysms from Infective Endocarditis: Insights into Pathophysiology and Current Treatment Approaches. Clinical Infectious Diseases, 68, 1391-1399.
[5]
Bayer, A.S., Shah, S.Y. and Ward, J. (2020) Current Challenges in the Management of Infective Endocarditis. Journal of the American College of Cardiology, 75, 1687-1705.
[6]
Hart, R.G., Foster, J.W. and Luther, M.F. (1990) Intracranial Hemorrhage as a Marker for Mycotic Aneurysm in Infective Endocarditis. Neurology, 40, 926-930.
[7]
Mavrogenis, A., Angelini, A., Guerra, G., et al. (2016) Management of Mycotic Aneurysms: A Systematic Review. European Journal of Vascular and Endovascular Surgery, 52, 326-336.
[8]
Majumdar, R., Alexander, M., Swain, M., et al. (2019) Endovascular Treatment of Mycotic Cerebral Aneurysms: A Meta-Analysis. Journal of Neurosurgery, 131, 843-853.
[9]
Zanaty, M., Chalouhi, N., Starke, R.M., et al. (2014) Endovascular Treatment of Cerebral Mycotic Aneurysms: A Systematic Review. Journal of Neurosurgery, 121, 832-839.
[10]
Muñoz, P., Kestler, M., De Alarcon, A., et al. (2015) Current Epidemiology and Outcome of Infective Endocarditis: A Multicenter, Prospective, Cohort Study. Medicine (Baltimore), 94, e1816. https://doi.org/10.1097/MD.0000000000001816
[11]
Murai, Y., Adachi, K. and Teramoto, A. (2014) Intracranial Infectious Aneurysms. Neurologia Medico-Chirurgica (Tokyo), 54, 475-481.
