alexa Ruptured Pulmonary Pseudoaneurysm in a Patient with Inf
ISSN: 2327-5146

General Medicine: Open Access
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Case Report

Ruptured Pulmonary Pseudoaneurysm in a Patient with Infectious Lung, Endocarditis, and Pulmonary Hypertension: Successful Treatment with Selective Transcatheter Embolization

Takeshi Sugahara*
Department of Radiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamine-minami, Higashi-ku, Kumamoto 861-8520, Japan
Corresponding Author : Takeshi Sugahara
Department of Radiology
Japanese Red Cross Kumamoto Hospital
2-1-1 Nagamine-minami, Higashi-ku
Kumamoto 861-8520, Japan
E-mail: [email protected]
Received July 09, 2013; Accepted July 29, 2013; Published August 05, 2013
Citation: Sugahara T (2013) Ruptured Pulmonary Pseudoaneurysm in a Patient with Infectious Lung, Endocarditis, and Pulmonary Hypertension: Successful Treatment with Selective Transcatheter Embolization. General Med 1:110. doi: 10.4172/2327-5146.1000110
Copyright: © 2013 Sugahara T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

A 65-year-old woman with a 14-year history of hypertension and chronic renal failure secondary to an unknown disease was admitted to our hospital after 2 days of fever, cough, dyspnea, and general fatigue. A chest radiograph obtained at the time of admission revealed an infiltrate in the left lower lobe suggestive of pneumonia. A transthoracic echocardiogram demonstrated vegetation on the mitral valve and pulmonary hypertension. On the 21st hospital day she suffered hemoptysis (approximately 300 cm3); emergent plain thoracic CT study revealed left lower lobe infiltration indicative of pneumonia. The attending physician continued aggressive antibiotic therapy. However, on the 35th day, she again manifested hemoptysis (450 cm3); emergent contrast-enhanced thoracic CT clearly showed a left pulmonary pseudoaneurysm within the left lung infiltrate. After consulting with her physician and interventional radiologists, we decided to deliver endovascular treatment and she underwent selective coil embolization with microcoils. Although the vegetation on the mitral valve persisted echocardiographically and her pulmonary hypertension was not abated, her clinical symptoms resolved. There has been no sign of recurrence 1 year after embolization.

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