2023 Volume 51 Issue 4 Pages 330-334
Infectious intracranial aneurysm is one of the complications of infective endocarditis (IE). However, few reported cases where several different types of bacteria were identified as responsible for its rupture exist. The present case is of a 75-year-old Japanese man who experienced an infectious intracranial aneurysm rupture 1 week after aortic valve replacement due to septic embolism from IE. CT angiography performed on onset revealed a 7-mm saccular aneurysm at the M1–M2 junction of the right middle cerebral artery. The patient had a history of aneurysmal clipping close to the lesion 9 years prior. The ruptured aneurysmal wall was resected for pathological examination after surgical obliteration of the aneurysm. Pathological findings revealed multiple bacteria, including Cryptococcus, Aspergillus, and colony formation of Gram-positive cocci. This case highlights the importance and challenge of identifying the responsible bacteria that caused the formation and rupture of infectious intracranial aneurysm.
