Balloon embolization of a mycotic pulmonary artery aneurysm

A patient presented to the hospital with mild hemoptysis of 1 day's duration and an infiltrate on chest roentgenogram. Shortly after admission, she developed shock, massive hemoptysis, and a bloody pleural effusion that yielded Streptococcus viridans. Pulmonary arteriography revealed a peripheral pulmonary artery aneurysm, which was embolized with a detachable silicone balloon, resulting in immediate cessation of hemoptysis. An acute pneumonia associated with moderate to massive hemoptysis raises the possibility of mycotic aneurysm; pulmonary arteriography is indicated, which allows for diagnosis and treatment during the same study. Successful embolization may obviate the need for surgery or convert an emergency thoracotomy to an elective procedure.