A MYCOTIC aortic ANEURYSM (MAA), synonymously known as infected aortic ANEURYSM, is an aortic ANEURYSM due to infection. MYCOTIC aortic ANEURYSM most commonly develops through microbial inoculation of the diseased aortic endothelium during bacteremia. In this study we presented 2 MYCOTIC aortic ANEURYSM cases. In the first case the patient is a 50-year-old farmer who presented with a complaint of abdominal pain. The patient was consulted with the vascular surgery service for the diagnosis of ruptured abdominal ANEURYSM. The patient was prepared for surgery of a ruptured abdominal aortic ANEURYSM. After surgery, the patient's blood culture was reported negative after 72 hours, but the patient's ANEURYSM sac tissue culture reported Citrobacter freundii. The patient's antibiotic treatment regimen was changed according to the performed antibiogram. In another case A 65 year’, s old male who was admitted in neurology ward was consulted with us, because of a pulsatile abdominal mass. The patient had Alzheimer disease and Brucellosis and didn’, t receive a complete duration treatment for his Brucellosis. On surgery, we bypassed the defect and covered the graft with peritoneum. In first case the patient's blood culture was reported negative after 72 hours, but the patient's ANEURYSM sac tissue culture reported Citrobacter freundii. The patient's antibiotic treatment regimen was changed according to the performed antibiogram. In second case he was discharged without any surgical complication and on follow –, up visit (7 months later) he didn’, t have any complaint.

Objective: Incidence of femoral artery MYCOTIC ANEURYSM is increasing due to rising rate of drug abusers. There are multiple surgical procedures for MYCOTIC ANEURYSM with different complications. Surgical treatments include extensive debridement and revascularization with autogen or synthetic grafts, primary or delayed and ligation of femoral artery without any revascularization. The aim of this study was to evaluate the outcome of femoral artery ligation in treatment of MYCOTIC ANEURYSM without revascularization among IV drug abusers.Subjects and Methods: This is a retrospective, descriptive study in 44 drug abusers who suffered from femoral MYCOTIC ANEURYSM who were referred to imam Khomeini and Razi Hospital during 2001-2004. All patients, operated on by just by femoral artery ligation and debridement without revascularization. Limb salvage and disability followed up for two years after operation.Results: In 2 cases (out of a total 44 cases) amputation was performed after femoral artery ligation (95% limb salvage). Intermittent claudication occurred in 5 cases (11.9%) and two (40 %) out of these 5 cases had delayed revascularization by synthetic graft prosthesis Paresthesia occurred in 2 cases.Conclusion: There are high complications with low success rate for primary revascularization in these patients either anatomical or extra anatomical due to extensive infection and sepsis.According to excellent surgical outcomes among our patients (95% limb salvage), we recommended that femoral artery ligation and debridement without any revascularization procedures be used. This method is safe, fast and effective in limb saving treatment for femoral MYCOTIC ANEURYSM in IV drug abusers.

Herein, we report a patient with arterio-venous fistula secondary to MYCOTIC ANEURYSM, causing high output heart failure. The patient had one-year history of refractory heart failure and recurrent pulmonary edema. This presentation is a good example of curative surgically treatable cause of high-output congestive heart failure.

MYCOTIC ANEURYSM of external carotid artery is extremely rare. We herein report a case of external carotid artery (ECA) ANEURYSM following severe traumatic brain injury. A 24-year-old man with severe traumatic brain injury (TBI) following a car accident was referred to Rajaee Trauma Center Emergency Room affiliated to Shiraz University of Medical Sciences in Shiraz, Iran. He underwent ventriculostomy on arrival for intracerebral pressure (ICP) monitoring and for a second time due to hydrocephalus following decompressive craniectomy.He developed fulminant meningitis and ventriculitis during his hospital course. A bulged pulsatile lesion under the frontotemporal scalp resulted into the suspicion to underlying vascular pathology. Six-vessel angiography of brain was done which revealed MYCOTIC ANEURYSM of external carotid artery. The patient underwent a two-week course of a combination of intravenous antibiotics. Follow-up angiography was performed which confirmed successful treatment of MYCOTIC ANEURYSM of ECA. MYCOTIC ANEURYSM of ECA is extremely rare. To our knowledge, this is the first report of MYCOTIC ANEURYSM of ECA following severe TBI which was successfully treated with antimicrobial therapy.

MYCOTIC ANEURYSMs are localized and irreversible dilatations of the arteries caused by weakening and damaging the arterial wall by an invasive organism establishing infective arteritis. MYCOTIC ANEURYSM of the thoracic aorta is a rare event; however, it can be fatal if not diagnosed early or not treated appropriately. Clinical findings are usually nonspecific; however, contrast-enhanced computed tomography (CT) is a common imaging modality of choice for the detection of MYCOTIC ANEURYSMs. Current management consists of antibiotic therapy and surgical treatment or endovascular interventions as early as possible. Herein, we present a case report of MYCOTIC ANEURYSM of the thoracic aorta as a postoperative complication in a 60-year-old female with a clinical history of the cardia and esophageal carcinoma who underwent thoracic surgery. The presence of MYCOTIC ANEURYSM was detected after performing a contrast-enhanced thoracic CT scan.

Introduction: ANEURYSM formation of internal carotid arteries (ICA) in patients with mucormycosis is a scarce phenomenon. However, the prevalence of rhino-cerebral mucormycosis has been reported to increase after the Coronavirus disease 2019 (COVID-19) pandemic. Case Presentation: Three patients with strokeandsubarachnoidhemorrhagepresenteddueto ICA ANEURYSMafter the involvement of adjacent paranasal sinuses (PNS) with mucormycosis. They had a history of diabetes and corticosteroid use. Also, one of them was treated with imatinib. Two out of the three patients were infected with SARS-CoV-2 before developing mucormycosis. Two patients had diagnostic angiography before endovascular intervention. One patient did not undergo any therapeutic intervention due to total artery occlusion, whereas the other patient experienced a successful parent artery occlusion by coiling and only survived this patient. Although all patients received antifungal treatment and surgical debridement, two of them died. Conclusions: In patients with rhino-cerebral mucormycosis, ANEURYSM evolution should be promptly and meticulously investigated by Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA). As this type of ANEURYSM is very fast-growing, as soon as the involvement of the sphenoid sinus is detected, the possibility of ICA ANEURYSM formation should always be kept in mind. If the patient develops an ANEURYSM, prompt intensive antifungal therapy and therapeutic endovascular interventions such as stenting, coiling, or sacrificing should be considered as soon as possible to optimize outcomes.

Regarding the increasing numbers of IV drug addicts, the incidence of infected pseudoANEURYSM is increasing. So far, different therapeutic strategies have been tried, but each method has its own drawbacks. Therefore, discovering an appropriate therapeutic method is necessary.65 patients with infected pseudoANEURYSM due to drug injection referred to Shohada Medical Center from Feb 1994 till Oct 2003 were chosen. After obtaining proximal control of the external iliac artery, femoral artery ligation was performed in all patients. The patients were observed for signs and symptoms of ischemia.After primary ligation of the involved artery, acute ischemia occurred in only 6 patients who later underwent extra-anatomical bypass. Only 3 patients underwent amputation. One of them was performed after extra-anatomical bypass and two cases after arterial ligation, as ischemia and gangrene had been present on admission. During patient follow up (minimum 3 months, maximum 3 years and average 12 months), 8 cases of slight claudication (9.3%) and 3 cases of severe claudication were reported and the rest have been symptom-free. Various treatments have been used for infected pseudoANEURYSM, but none of them are faultless. According to infection of the site and existence of extensive necrosis and inflammatory tissue, anatomical and even non-anatomical bypasses are almost improbable. The results of this study indicate that arterialligation could be the first and probably the best choice of treatment in such patients with less cost and also without mentionable morbidity or mortality. This procedure must be performed in a vascular surgery center to perform vascular bypass if needed.

Intracranial ANEURYSMs are relatively common, with a prevalence of approximately 4%. Unruptured ANEURYSMs may cause symptoms mainly due to a mass effect, but the real danger is when an ANEURYSM ruptures, leading to a subarachnoid hemorrhage. Most ANEURYSMs are asymptomatic and will not rupture, but they grow unpredictably and even small ANEURYSMs carry a risk of rupture. There are many risk factors for the development of intracranial ANEURYSMs, both inherited and acquired. Females are more prone to ANEURYSM rupture, with subarachnoid hemorrhage (SAH) 1.6 times more common in women. The prevalence of ANEURYSM increases in certain genetic diseases. There are four main types of intracranial ANEURYSMs: saccular, fusiform (atherosclerotic or dolichoectatic type/congenital type), dissecting, and the MYCOTIC type. The saccular type accounts for 90% of intracranial ANEURYSMs. We observed some patients who were referred for diagnosis and further angiographic evaluation. They had presented with various histories and clinical findings. Their imaging findings such as CT scan, CTA, MRI and MRA findings were unusual. Every one of these patients has an uncommon form of ANEURYSM which could be misdiagnosed with other conditions or might need special and different treatment and knowledge of these situations could be of great help. 

Background: Infectious endocarditis is a rare complication in burned patients that causes mortality and morbidity.Methods: We report a 3-year old girl with prolonged fever after boiled water burning, two months ago. She experienced fourteen sections of surgical debridement and grafting. Huge vegetation on the tricuspid valve and mild pericardial effusion with some debris were detected during sepsis work up. At the same time multiple resistant pseudomonas aeruginosa was grown in blood culture which was only sensitive to colestin.Findings: Inserting pericardial window, 20 ml pus was drained and huge MYCOTIC aortic ANEURYSM was detected. Despite anti- microbial therapy, replacing tricuspid valve with a synthetic one, and aortic graft, she died with a severe endophthalmitis.Conclusion: Infectious endocarditis should be considered in febrile burned patients. Also ophthalmic evaluation seems necessary in a patient who has had a surgery for MYCOTIC ANEURYSM.