prognosis of infected aneurysm?

Answer 1

donna - LovingHeart basically does an internet search and posts the abstract of a randomly chosen study. It does NOT necessarily apply to your situation. The prognosis of an infected aneurysm (also known as a mycotic aneurysm) varies depending on the location, the organism, and how soon the diagnosis is made.

Mycotic aneurysms are RARE. That is why most published studies (such as the one LovingHeart reports) have very few patients. However, because they involve very small numbers, it is hard to know how that applies to other cases.

As a case in point, the Mayo Clinic reported on a series of 11 patients who were diagnosed with mycotic aneurysm of the thoracic aorta over a 25 year period. 2 patients who died in the 1970s died before undergoing surgery. In the remaining 9, only one patient died during surgery. The remaining 8 patients were still alive at an average follow-up of 19 months after surgery. Even if you include the two who died without surgery, that amounts to a survival rate of 72% at 19 months. This is very different from the 20% survival rate at 2 years in LovingHeart's study.

Another study from Germany reviewed 33 patients with mycotic aneurysms of the thoracic aorta, abdominal aorta, or iliac arteries. In their study, at an average of 30 months of follow-up, 33% of the patients were alive and well. Another 30% had died after being discharge from the hospital for unrelated reasons.

So three randomly chosen studies show 20% survival, 30% survival and 70% survival. As you can see, we can't depend on any single study to tell us what the odds of survival are. The best anyone can say is that mycotic aneurysms are very serious and frequently fatal without surgery. With prompt surgery and IV antibiotics, the survival is much better and falls somewhere between 40% and 80% two years after surgery. I know that's probably not the simple answer you were looking for, but it's important for you to know the facts.

Hope that helps!

Answer 2

Report of 5 year experience of 10 cases of mycotic aneurysms of the aorta caused by salmonella infection. Of the 10 patients, nine were males and one was female in an age range from 60 to 80 years with a mean of 71 years. The major clinical manifestations were fever, abdominal or back pain, pulsatile abdominal mass and leucocytosis. The diagnosis was based on clinical symptoms and signs and positive blood or tissue cultures. The main confirmatory procedure was computed tomography (CT). Two year survival rate was 20%. Five patients died during hospitalisation, without surgery. Three patients died within 2 months of surgery. The other two patients, treated surgically and by intensive antibiotic therapy, survived. Death resulted usually from recurrent infection and graft leakage. Contrary to previous reports, salmonella mycotic aneurysm is still common in this geographical area and the prognosis is poor.

In psoas Abscess rupture of abdominal aorta, but it is extremely rare.