from Part VI - Clinical Syndromes – Heart and Blood Vessels
Published online by Cambridge University Press: 05 March 2013
Diagnosis and treatment of vascular infections is complex and depends on a variety of factors, including the location of the infected tissue, the microbiology of the infection, and patient-specific factors, such as anatomy and immune status. Purulent or suppurative thrombophlebitis is inflammation of a peripheral or central venous wall because of the presence of microorganisms. Endarteritis (or infective arteritis) and mycotic aneurysms are infections of the arterial walls; arterial aneurysms or pseudoaneurysms are usually present because endarteritis may be difficult to diagnose unless an aneurysm is present. The term mycotic aneurysm is a misnomer that refers to any arterial aneurysm of infectious cause, fungal or bacterial, and may also include secondary infections of preexisting aneurysms or pseudoaneurysms. Vascular graft infections present an even wider spectrum of disease that depends on the type and location of the graft. Management of infections located on vascular prostheses is further complicated by the fact that prosthesis excision can jeopardize a patient's life and organ function, and alternative grafting techniques, including ex situ bypass, autologous reconstruction, and a variety of other graft materials must be considered. Finally, endovascular repair of aneurysms has resulted in a variety of infectious complications of endovascular stents, stent-grafts, and other intra-arterial devices.
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