Pediatr Infect Vaccine.  2017 Dec;24(3):183-187. 10.14776/piv.2017.24.3.183.

Infectious Pseudoaneurysm Caused by Group A Streptococcus in a Child without Underlying Disease

• Kim KH
• Lee H
• Oh CE

• KMID: 2401394
• DOI: http://doi.org/10.14776/piv.2017.24.3.183

Abstract

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascularrelated underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

Keyword

Streptococcus pyogenes; Aneurysm, infected; Scarlet fever; Child

MeSH Terms

Aneurysm, False*
Aneurysm, Infected
Anti-Bacterial Agents
Bacteremia
Child*
Child, Preschool
Diagnosis
Exanthema
Fever
Humans
Iliac Artery
Leg
Male
Pediatrics
Pharyngitis
Scarlet Fever
Streptococcus pyogenes
Streptococcus*
Thoracic Surgery
Anti-Bacterial Agents

Figure

• 

  Figure 1 Bone scan. There are increased perfusion and blood pool activity on right sacroiliac joint (solid lines).

• 

  Figure 2 (A) Magnetic resonance imaging of lower extremities. Fusiform signal void with heterogeneously high signal lesion (asterisk) seems to be arising from right internal iliac artery. (B) Computed tomography angiography of lower extremities. There is a large pseudoaneurysm in pelvic cavity, which originates from the anterior branch of right internal iliac artery (arrow).

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  Figure 3 (A) The clinical course before the operation. (B) The clinical course after the operation. Abbreviations: HD, hospital day; VAS, visual analogue scale for pain; HS-CRP, high-sensitivity C-reactive protein; WBC, white blood cell; Sono, ultrasonography; MRI, magnetic resonance imaging; Angio CT, computed tomography angiography; POD, postoperative day; IVIG, intravenous immunoglobulin; S. pyogenes, Streprococcus pyogenes.

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