Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis – A case report and a review of the literature

• Published in: International journal of surgery case reports 2018-01, Vol.50, p.92-96
• Main Authors: Benhassen, Leila Louise, Højsgaard, Anette, Allan Terp, Kim, de Paoli, Frank Vincenzo
• Format: Article
• Language: English
• Subjects: Aneurysm; Case report; Hemoptysis; Midline surgical approach; Pulmonary artery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2018.07.029

•Mycotic aneurysms of the pulmonary arteries are very rare with high mortality.•Risk groups are IV drug users and patients with congenital heart disorders.•Symptoms are often non-specific and may cause a diagnostic delay.•When hemoptysis is present, the suspicion of a pulmonary aneurysm should be raised.•For rapidly progressing proximal aneurysms, a midline approach is recommended. Mycotic aneurysms of the pulmonary arteries are very rare and have high mortality. Risk groups are intravenous drug users and patients with congenital heart disorders. The surgical approach varies due to a limited number of reported cases. We present a case of a mycotic aneurysm of the right pulmonary artery in a 56-year old man presenting with recurrent pneumonias, weight loss and hemoptysis. There is often a diagnostic delay because of non-specific symptoms mimicking more common disorders. Treatment strategies include conservative management, surgery and endovascular treatment. This report demonstrates a rare case of aneurysm of the pulmonary artery presenting with hemoptysis. For rapidly progressing proximal aneurysms of the pulmonary arteries, the midline surgical approach is recommended.