Journal Article

Fungal Internal Carotid Artery Aneurysms: Successful Embolization of an <i>Aspergillus</i>-Associated Case and Review

Arnaud Hot, Mikaël Mazighi, Marc Lecuit, Sylvain Poirée, Jean-Paul Viard, Pierre Loulergue, Felipe Suarez, Bertrand Dupont, Jean-Jacques Merland and Olivier Lortholary

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 12, pages e156-e161
Published in print December 2007 | ISSN: 1058-4838
Published online December 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/523005
Fungal Internal Carotid Artery Aneurysms: Successful Embolization of an Aspergillus-Associated Case and Review

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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.

Journal Article.  2645 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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