Mucormycotic pseudoaneurysm of the common carotid artery with tracheal involvement

Mycoses. 2008 Jul;51(4):347-51. doi: 10.1111/j.1439-0507.2007.01487.x.

Abstract

Mucormycosis is an emerging and fatal fungal infection. A high index of suspicion and the knowledge of its potential manifestations are essential for early diagnosis. We describe a patient with acute lymphoblastic leukaemia (L2 subtype) who developed a neck mass following a course of induction chemotherapy. Doppler ultrasonography and angiography of the neck revealed a pseudoaneurysm of the right common carotid artery. The patient then developed haemoptysis. Surgical exploration revealed a necrotic right common carotid artery with anteromedial pseudoaneurysm and adjacent tracheal wall perforation. Local debridement and tracheal repair were performed. Nonseptate hypheal invasion (mucormycosis) was found on the microscopic examination of the excised arterial wall. A subsequent recurrence of pseudoaneurysm was treated with local surgical debridement and intravenous amphotericin B (Fungizone) administration. Although rare, clinicians should be aware of these possible presenting features of mucormycosis as early diagnosis and treatment may potentially improve the survival.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Aneurysm, False / microbiology*
  • Antifungal Agents / therapeutic use
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / microbiology*
  • Carotid Artery, Common / surgery
  • Humans
  • Male
  • Mucorales / cytology
  • Mucormycosis / complications*
  • Mucormycosis / diagnosis*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Radiography
  • Tracheal Diseases / etiology
  • Tracheal Diseases / surgery
  • Ultrasonography

Substances

  • Antifungal Agents
  • Amphotericin B