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Treatment of a large pulmonary artery pseudoaneurysm secondary to fungal infection using Amplatzer plugs: New embolisation devices for the management of haemoptysis.

Chellamuthu S, Bottomley JR - Respir Med Case Rep (2011)

Bottom Line: Pulmonary artery pseudoaneurysms (PAP) may result in life threatening haemoptysis but are fortunately uncommon.We describe a case of large PAP secondary to fungal infection in an immunocompromised patient, which was successfully treated percutaneously using Amplatzer embolisation plugs.The technical considerations and advantages of these new devices are explained.

View Article: PubMed Central - PubMed

Affiliation: Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Herries Rd, S57AU, Sheffield, United Kingdom.

ABSTRACT
Pulmonary artery pseudoaneurysms (PAP) may result in life threatening haemoptysis but are fortunately uncommon. Most are caused by trauma, iatrogenic injury or infection. We describe a case of large PAP secondary to fungal infection in an immunocompromised patient, which was successfully treated percutaneously using Amplatzer embolisation plugs. The technical considerations and advantages of these new devices are explained.

No MeSH data available.


Related in: MedlinePlus

Initial AP erect chest radiograph showing right upper lobe consolidation and a bulging horizontal fissure consistent with lobar pneumonia. There is an incidental hiatus hernia behind the heart.
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fig1: Initial AP erect chest radiograph showing right upper lobe consolidation and a bulging horizontal fissure consistent with lobar pneumonia. There is an incidental hiatus hernia behind the heart.

Mentions: A 76-year old male with a three-year history of Myelodysplasia presented with symptoms and signs of right upper lobe pneumonia. Initial investigations revealed neutropenia (neutrophil count 1.0) for which he was commenced on Clarithromycin, Tazocin and Gentamicin. Blood and sputum cultures for bacteria including acid-fast bacilli and urinary antigen for Legionella were negative. A chest x-ray confirmed right upper lobar pneumonia with a bulging horizontal fissure (Fig. 1). On going high-grade pyrexia and haemoptysis prompted a change of antibiotic regime to include antifungal agents after repeat sputum cultures grew Stenotrophomonas maltophilia and Candida melibiosica. A contrast enhanced CT chest was performed to investigate the cause of haemoptysis. This demonstrated right upper lobe pneumonia as well as a large pulmonary artery pseudoaneurysm (Fig. 2).


Treatment of a large pulmonary artery pseudoaneurysm secondary to fungal infection using Amplatzer plugs: New embolisation devices for the management of haemoptysis.

Chellamuthu S, Bottomley JR - Respir Med Case Rep (2011)

Initial AP erect chest radiograph showing right upper lobe consolidation and a bulging horizontal fissure consistent with lobar pneumonia. There is an incidental hiatus hernia behind the heart.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150616&req=5

fig1: Initial AP erect chest radiograph showing right upper lobe consolidation and a bulging horizontal fissure consistent with lobar pneumonia. There is an incidental hiatus hernia behind the heart.
Mentions: A 76-year old male with a three-year history of Myelodysplasia presented with symptoms and signs of right upper lobe pneumonia. Initial investigations revealed neutropenia (neutrophil count 1.0) for which he was commenced on Clarithromycin, Tazocin and Gentamicin. Blood and sputum cultures for bacteria including acid-fast bacilli and urinary antigen for Legionella were negative. A chest x-ray confirmed right upper lobar pneumonia with a bulging horizontal fissure (Fig. 1). On going high-grade pyrexia and haemoptysis prompted a change of antibiotic regime to include antifungal agents after repeat sputum cultures grew Stenotrophomonas maltophilia and Candida melibiosica. A contrast enhanced CT chest was performed to investigate the cause of haemoptysis. This demonstrated right upper lobe pneumonia as well as a large pulmonary artery pseudoaneurysm (Fig. 2).

Bottom Line: Pulmonary artery pseudoaneurysms (PAP) may result in life threatening haemoptysis but are fortunately uncommon.We describe a case of large PAP secondary to fungal infection in an immunocompromised patient, which was successfully treated percutaneously using Amplatzer embolisation plugs.The technical considerations and advantages of these new devices are explained.

View Article: PubMed Central - PubMed

Affiliation: Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Herries Rd, S57AU, Sheffield, United Kingdom.

ABSTRACT
Pulmonary artery pseudoaneurysms (PAP) may result in life threatening haemoptysis but are fortunately uncommon. Most are caused by trauma, iatrogenic injury or infection. We describe a case of large PAP secondary to fungal infection in an immunocompromised patient, which was successfully treated percutaneously using Amplatzer embolisation plugs. The technical considerations and advantages of these new devices are explained.

No MeSH data available.


Related in: MedlinePlus