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Vol. 102. Issue 2.
Pages 142-145 (March 2011)
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Vol. 102. Issue 2.
Pages 142-145 (March 2011)
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Septic Emboli to the Skin Following Angioplasty
Embolismos sépticos cutáneos tras angioplastia
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6952
L. Sanz-Canalejasa,
Corresponding author
, U. Floristán-Muruzábala, M. Feito-Rodrígueza, E. Sendagorta-Cudósa, M.J. Beato-Merinob, P. Herranz-Pintoa
a Departamento de Dermatología, Hospital Universitario La Paz, Madrid, Spain
b Departamento de Anatomía Patológica, Hospital Universitario La Paz, Madrid, Spain
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Abstract

Invasive vascular procedures have good efficacy and safety profiles and are now widely used for the diagnosis and treatment of many cardiovascular disorders. However, they do have potential complications that can occasionally be life-threatening. We present a new case of infectious pseudoaneurysm following percutaneous transluminal coronary angioplasty and complicated by septic emboli to the skin. It is a rare condition characterized by persistent bacteremia, sepsis of unknown origin, and regional septic emboli. Histopathology of the skin lesions typically reveals gram-positive coccobacilli and septic vasculitis. The condition carries a significant morbidity and mortality, making early diagnosis essential. Both cholesterol and septic emboli should be considered in the differential diagnosis of skin lesions after invasive vascular procedures.

Keywords:
Pseudoaneurysm
Percutaneous transluminal coronary angioplasty
Staphylococcus aureus
Purpura
Resumen

Los procedimientos vasculares invasivos son en el momento actual ampliamente utilizados para el diagnóstico y tratamiento de muchas patologías del sistema cardiovascular, con un buen perfil de seguridad y eficacia, aunque entrañan potenciales complicaciones que ocasionalmente pueden comprometer la vida del paciente. Presentamos un nuevo caso de pseudoaneurisma infeccioso postangioplastia complicado con embolismos sépticos cutáneos. Se trata de una entidad infrecuente caracterizada por bacteriemia persistente, sepsis sin foco aparente y embolismos sépticos regionales. El análisis histopatológico de las lesiones cutáneas habitualmente permite evidenciar la presencia de cocobacilos Gram positivos y de vasculitis séptica. Es una entidad con una importante morbimortalidad, por lo que el diagnóstico precoz resulta esencial. Por ello, ante lesiones cutáneas tras procedimientos vasculares invasivos deben considerarse en el diagnóstico diferencial no solo los embolismos de colesterol, sino también los embolismos sépticos.

Palabras Clave:
Pseudoaneurisma
Angioplastia coronaria transluminal percutánea
Staphylococcus aureus
Púrpura
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Copyright © 2011. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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