A Case of Intracranial Mycotic Aneurysms that was Complicated by Infectious Endocarditis

Abstract

The authors describe a case of subarachnoid hemorrhage due to the rupture of intracranial mycotic aneurysms and complicated by infectious endocarditis. The patient, a 46-year-old male with a mitral insufficiency, had a high fever that had persisted for 5 months. He was diagnosed as having infectious endocarditis, caused by α-streptococcus, and was being treated with Penicillin G and Amikacin. However, during this therapy he developed subarachnoid hemorrhage. Angiography confirmed that mycotic aneurysms were responsible for the hemorrhage and Penicillin G continued to be administered. However, 12 days after the initial bout of subarachnoid hemorrhage, aneurysmal rebleeding occurred and he died. The authors emphasize the difficulty of developing an effective strategy for managing ruptured intracranial mycotic aneurysms and discuss the treatment of this disease with a review of the pertinent literature.