Clinical Entity of Cryptogenic Mycotic Aneurysm

The term cryptogenic has been applied to a type of mycotic aneurysm caused by the deposition of antibiotic resistant organisms into or onto a site of arteriosclerosis. The causative salmonellas and staphylococci give rise to a suppurative arteritis which progresses to rupture. Before the vessel wall gives way, diagnosis is usually not possible because of the absence of localizing signs. After rupture the identity of the lesion becomes obvious, with an immediate threat to life and limb. Treatment is surgical, consisting of excision of the diseased segment with graft substitution to maintain the arterial flow. In contrast to the embolomycotic type of aneurysm associated with subacute bacterial endocarditis, the crytogenic variety is increasing in frequency.