MULTIPLE MYCOLIC ANEURYSMS AND PERIPHERAL EMBOLI DURING INFECTIOUS ENDOCARDITIS - REPORT OF ONE CASE

Sepsis from an infected cardiac valve can lead to bacterial seeding an d destruction of the arterial wall with formation of a mycotic aneurys m. The natural history of these lesions is the rupture. We report the case of a 20 year old female who was admitted to our institution with massive mitral regurgitation and emboli of the central nervous system and both lower extremities. She underwent emergency valve replacement and then, staged treatment of her ischemic legs and multiple asymptoma tic mycotic aneurysms. Superior mesenteric, right common iliac and lef t superficial femoral arteries. A splenectomy was required to treat a splenic abscess. An aneurysm of a peripheral branch of the middle cere bral artery was medically treated, demonstrating reduction in size on subsequent angiogram. She recovered uneventfully and remains asymptoma tic aster 20 months of follow up. The development of new diagnostic an d therapeutic tools has led to a decrease of these complications durin g infectious endocarditis. However, in the patient with late diagnosis and symptoms in different territories, the mycotic aneurysm must be k ept in mind to provide the patient with appropriate treatment.