[A case of multiple mycotic XXXX ].

@entity1 @entity5880 @entity438 @entity1269 @entity73 @entity1410 @entity439 @entity10 @entity884
A @entity1 with multiple @entity5880 associated with @entity884 is reported. A 45-year-old @entity1 was admitted on February 16, 2001 under the diagnosis of @entity884 . After alpha-streptococcus was identified by a blood culture, he was treated with high doses of antibiotics. However, 2 weeks after admission, he suddenly suffered from @entity10 and mild @entity1269 . A CT showed a parenchymal @entity1410 in the right parietal lobe. Cerebral angiography demonstrated @entity439 of the bilateral middle cerebral artery and the left posterior cerebral artery. At first, we trapped and resected the ruptured right @entity438 . After the surgery, we tried to treat two @entity439 by endovascular treatment. During the provocation test for the posterior cerebral artery, the arterial wall was perforated by a guide wire. The parent artery was occluded by coils at this site. Although the @entity439 was still filled by retrograde blood flow, it finally disappeared six months after treatment. The left @entity438 could not be treated because the provocation test showed @entity73 . The @entity1 recovered from @entity884 after four-months of antibiotic therapy; and the unruptured @entity439 had not changed in size for 11 months. Recently, the outcome of @entity1 with @entity438 is improved by development of multimodality management. Especially, endovascular therapy may become an effective treatment for @entity439 , but it is necessary to take risks, such as arterial perforation into consideration.
