Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis With Left Ventricular Assist Device and Implantable Cardiac Defibrillator Device: A Clinical Course

Transplant Proc. 2018 Dec;50(10):4064-4066. doi: 10.1016/j.transproceed.2018.08.027. Epub 2018 Sep 7.

Abstract

We report the first case of a ruptured intracranial aneurysm-related Staphylococcus epidermidis bacteremia in a patient supported by a continuous flow left ventricular assist device (LVAD). Mycotic aneurysms (MAs) are aneurysmal degeneration of the arterial wall as a result of infection. Current recommendations for management of intracranial mycotic aneurysms are based on a few retrospective case studies. There are only a few cases of intracranial MA reported in patients with LVAD infections caused by Pseudomonas aeruginosa and Klebsiella rhinos. Here, we describe the first case of a ruptured intracranial aneurysm caused by a less virulent organism (Staphylococcus epidermidis) and conclude that screening for asymptomatic MA should be strongly considered in patients with persistent LVAD- and implantable cardiac defibrillator pacemaker-associated infections.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Infected / microbiology*
  • Defibrillators, Implantable / adverse effects*
  • Defibrillators, Implantable / microbiology
  • Endocarditis, Bacterial / complications*
  • Female
  • Heart-Assist Devices / adverse effects*
  • Heart-Assist Devices / microbiology
  • Humans
  • Intracranial Aneurysm / microbiology*
  • Middle Aged
  • Retrospective Studies
  • Staphylococcal Infections / complications*
  • Staphylococcus epidermidis