Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India

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The major vessels involved are femoral, aorta, then intracranial visceral arteries and pulmonary arteries. These aneurysms are identified by their fusiform shape, multiple, distal location involving the entire wall of the vessel and changing morphology on repeat imaging studies. The study aims to discuss the clinical presentation & management of post infectious aneurysms. Methods This is a retrospective study of 11 case series of postinfectious aneurysms over a period of 10 years admitted at a tertiary care hospital. The detailed clinical data that included the clinical presentation, diagnostic and treatment was studied from the hospital medical records department and laboratory information system. Results Among the 11 patients diagnosed with aneurysms, 4 presented with intracranial, 4 with intra pulmonary and 3 with intra-abdominal aortic aneurysms involvement. Source was either of bacterial cause such as E.coli, Streptococcus gallolyticus, Salmonella Typhi, M. tuberculosis, Klebsiella pneumoniae, Methicillin Resistant S. aureus, S. hominis or fungal origin being Aspergillus spp. All of them had elevated C-reactive protein level, ESR and confirmed by positive cultures or Xpert Tb. Management of mycotic aneurysm includes imaging studies along with laboratory workup, endovascular intervention with intravenous antibiotics, or a combination of these. Conclusion High index of suspicion in patients presenting with fever, elevated C-reactive protein, ESR, total counts with sudden development of atypical aneurysms requires timely blood culture pre and post procedure. Definitive surgical/endovascular under antibiotic coverage at the earliest is a prerequisite in the management to prevent re-rupture. 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F1000Research 2025, 14 :1356 ( https://doi.org/10.12688/f1000research.171966.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] Keerthiraj B 1 , Bergin C https://orcid.org/0009-0002-0471-7351 1 , Pooja Rao https://orcid.org/0000-0003-0717-783X 1 , Udayalaxmi Jeppu 1 Keerthiraj B 1 , Bergin C https://orcid.org/0009-0002-0471-7351 1 , Pooja Rao https://orcid.org/0000-0003-0717-783X 1 , Udayalaxmi Jeppu 1 PUBLISHED 03 Dec 2025 Author details Author details 1 Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India Keerthiraj B Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Bergin C Roles: Data Curation, Formal Analysis, Investigation, Methodology, Resources, Validation, Writing – Original Draft Preparation Pooja Rao Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Udayalaxmi Jeppu Roles: Formal Analysis, Investigation, Resources, Supervision, Validation, Visualization, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background and aims Infectious aneurysm is an aneurysm of the arteries originating from endogenous bacteraemia due to bacterial or fungal origin. The major vessels involved are femoral, aorta, then intracranial visceral arteries and pulmonary arteries. These aneurysms are identified by their fusiform shape, multiple, distal location involving the entire wall of the vessel and changing morphology on repeat imaging studies. The study aims to discuss the clinical presentation & management of post infectious aneurysms. Methods This is a retrospective study of 11 case series of postinfectious aneurysms over a period of 10 years admitted at a tertiary care hospital. The detailed clinical data that included the clinical presentation, diagnostic and treatment was studied from the hospital medical records department and laboratory information system. Results Among the 11 patients diagnosed with aneurysms, 4 presented with intracranial, 4 with intra pulmonary and 3 with intra-abdominal aortic aneurysms involvement. Source was either of bacterial cause such as E.coli, Streptococcus gallolyticus, Salmonella Typhi, M. tuberculosis, Klebsiella pneumoniae , Methicillin Resistant S. aureus, S. hominis or fungal origin being Aspergillus spp. All of them had elevated C-reactive protein level, ESR and confirmed by positive cultures or Xpert Tb. Management of mycotic aneurysm includes imaging studies along with laboratory workup, endovascular intervention with intravenous antibiotics, or a combination of these. Conclusion High index of suspicion in patients presenting with fever, elevated C-reactive protein, ESR, total counts with sudden development of atypical aneurysms requires timely blood culture pre and post procedure. Definitive surgical/endovascular under antibiotic coverage at the earliest is a prerequisite in the management to prevent re-rupture. READ ALL READ LESS Keywords Mycotic aneurysm; pulmonary artery aneurysm; post infectious aneurysm; case series aneurysm Corresponding Author(s) Pooja Rao ( [email protected] ) Close Corresponding author: Pooja Rao Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 B K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: B K, C B, Rao P and Jeppu U. Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] . F1000Research 2025, 14 :1356 ( https://doi.org/10.12688/f1000research.171966.1 ) First published: 03 Dec 2025, 14 :1356 ( https://doi.org/10.12688/f1000research.171966.1 ) Latest published: 03 Dec 2025, 14 :1356 ( https://doi.org/10.12688/f1000research.171966.1 ) Introduction Infectious aneurysms are a rare type of intracranial aneurysm distinguished from the more common berry aneurysms by their infectious origin, occurrence in younger individuals, multiple occurrences, and distal aneurysm locations. The key histopathological feature of these aneurysms is infection and arterial wall destruction. 1 Consequently, they are pseudoaneurysms that can arise from infections spread through endovascular means (such as infective endocarditis) or extravascular means (such as meningitis). The term “infectious aneurysm” is likely more appropriate than MA, as these aneurysms can be caused by various bacteria, fungi, mycobacteria, and viruses. The most frequently involved organisms are Streptococcus viridans and Staphylococcus aureus. It most commonly presents as intracranial hemorrhage, and, compared with other aneurysms, it has a greater risk of rupture and fatal bleeding. 2 Materials and methods An analytical, cross-sectional study was conducted over a 10-year period from 2013 2023 at a tertiary care centre in Southern India. The study was approved by the Institutional Ethics Committee (IEC) of Kasturba Medical College, Mangalore with Reg no. IEC KMC MLR 07/2024/476. In compliance with the Declaration of Helsinki, the IEC granted the patient consent waiver to review the medical records where the participants could not be contacted, and there was absolutely no risk to the patient, with all the data being anonymized. Symptomatic patients admitted to the hospital with a diagnosis of postinfectious aneurysm by imaging studies were considered during the study period. The ethics committee waived the need to obtain informed consent, as the data were obtained from the laboratory information system and hospital medical records department of the attached hospitals, and the tests and procedures performed were part of the investigations ordered for the patient during the routine course of diagnosis and treatment. The inclusion criterion was symptomatic patients admitted to the hospital and diagnosed with postinfectious aneurysms during the investigation workup. The exclusion criterion was patients with aneurysms of noninfectious origin. The clinical and laboratory parameters, imaging studies and management of the patients, as well as their outcomes, such as recovery/death, were captured via Excel software. The data were analysed with the help of frequencies and proportions for categorical values, whereas the quantitative data were expressed as means, medians, and proportions. Results Eleven cases were considered via the convenience sampling method during the study period. Four patients presented with intracranial aneurysms, 4 with intrapulmonary aneurysms and 3 with intraabdominal aortic aneurysms ( Table 1 ). The median age of these patients was 58 years, and these patients were more common among males than females ( Table 2 ). Table 1. Summary of 11 cases with infectious aneurysms. Case Aneurysm number Location Shape Size Diagnosis Procedure 1 1 Abdominal aorta Saccular 26 × 15 mm Abdominal aortic aneurysm DSA aortogram and endovascular covered stent placement 2 1 Abdominal aorta NA NA Abdominal aortic active leak with retro peritoneal haematoma Aortogram and endovascular aortic stent graft placement along with inj. Teicoplanin followed by Linezolid 3 1 Abdominal aorta Saccular 5 × 5.6 cms Infrarenal abdominal aortic aneurysm Endovascular aortic stent graft placement for infrarenal abdominal aortic aneurysm with partial thrombus and contained rupture along with injection ceftriaxone 4 2 Left & right ACA Fuso saccular 2.7 × 2.6 mm & 2.8 × 2.5 mm Stroke, left parieto occipital lobe bleed, B/L distal Ant cerebral artery Endovascular glue embolization with parent artery occlusion of distal pericallosal artery branch of left ACA and distal inferior parietal branch of right ACA post infectious 5 30-35 (multiple) ICA, MCA, ACA, PICA Fusiform NA Intracranial bleed, aneurysm rupture with cutaneous Nocardiosis DSA and I. V Meropenem & tab cotrimoxazole 6 1 MCA Fuso saccular 11 × 22 mm Intraparenchymal haemorrhage (left parietal of MCA aneurysm) Endovascular glue embolization of parietal branch of left MCA with parent artery occlusion for left MCA parietal branch 7 1 Right Distal ACA Irregular saccular 3.9 × 3.6 mm SAH with ruptured intracranial aneurysm DSA cerebral angiogram, endovascular coiling (coil trapping) of ruptured right DACA irregular saccular aneurysm with intravenous Meropenem 8 1 Right Pulmonary artery NA 2 × 2.2 × 2.5 cm Pulmonary artery pseudoaneurysm PVA particles embolization of right bronchial artery and CT guided percutaneous glue injection for left upper lobar apico-posterior segment pulmonary artery pseudoaneurysm 9 1 Right Pulmonary artery branch aneurysm NA 1 × 1 cm Rasmussen aneurysm Percutaneous glue embolization of right upper lobe posterior segment pulmonary artery branch aneurysm (Rasmussen aneurysm) with complete obliteration of the pseudoaneurysm from the circulation with no active leak and normal filling of rest of the right pulmonary artery 10 1 Right pulmonary artery NA 7.5 × 8 cm Pulmonary artery pseudoaneurysm Endovascular amplatz vascular plug, coil, glue embolization of large right lower lobe pulmonary artery aneurysm with complete obliteration of aneurysm and persisting flow in right upper lobe pulmonary artery 11 1 Right pulmonary artery NA 4 × 1.4 × 2.3 cms Large pulmonary artery aneurysm DSA & CT guided glue and coil embolization of partially thrombosed large pulmonary artery aneurysm Table 2. Clinical profile of 11 cases presenting with infectious aneurysm. Case Clinical presentation Age/Gender Organism Comorbidities 1 Fever since 4 days, Severe lower abdominal pain 66/F S hominis Hypertension, diabetes 2 Fever, lower abdominal & flank pain since 1 week 59/M Methicillin Resistant Staphylococcus aureus Diabetes, hepato-splenomegaly, renal calculi 3 Lower abdominal pain, constipation since 1 week and hypovolemic shock 62/M S Typhi Hypertension, hypercholesterolemia 4 Headache since 2 months, sudden onset of left hemiplegia 58/M S gallolyticus NIL 5 Fever, vomiting, nausea generalized weakness since 1 day 62/F Nocardia spp CKD * /HTN † /post kidney transplant/UTI ‡ 6 Fever, vomiting with seizures 23/M Streptococcus mitis (viridans group) IE of mitral valve, Anemia 7 Headache, altered sensorium, low Glass glow Coma Scale 65/M Klebsiella pneumoniae H/O fall, Hypertension 8 Recurrent massive haemoptysis 52/M Mycobacterium tuberculosis NA 9 Recurrent haemoptysis with cavitary lesion 62/M Mycobacterium tuberculosis NA 10 Hemoptysis 65/M Aspergillus fumigatus NA 11 Massive hemoptysis 64/M Mycobacterium tuberculosis NA * Chronic Kidney Disease; † Hypertension; ‡ Urinary tract Infections. The size of the aneurysms was small (<5 mm) in 3 patients, whereas large aneurysms were noted in the remaining 6 patients. All these patients had elevated C-reactive protein levels and ESRs. No immediate postoperative complications were observed. The sources of these postinfectious aneurysms were bacterial or fungal in origin ( Table 2 ). The identification was based on blood culture or GeneXpert for tuberculosis or fungal culture results. CT angiogram, digital subtraction angiography (DSA) or ultrasonography are considered important diagnostic tools ( Table 1 ) ( Figure 1 ). Figure 1. A) Pre procedure: CT angiogram of intra-abdominal aorta aneurysm. B) Pre procedure: Aortogram showing infrarenal abdominal aortic saccular aneurysm. C) Post procedure: Aortogram showing no filling of the aneurysm. Management was either endovascular with coil placement or embolization along with appropriate antibiotic therapy ( Table 1 ). During follow-up, no patients experienced recurrence or rebleeding. One patient with cutaneous nocardiosis with multiple saccular aneurysms died because of intracranial bleeding. Endovascular intervention could not be performed because there were multiple aneurysms. Discussion Sir William Osler coined the term “mycotic aneurysm” in 1885 because of its appearance as a mushroom. 3 The term primary infectious aneurysm is best suited for aneurysms of arteries that develop immediately because of an infectious cause. These aneurysms account for no more than 3% of all aneurysms in the West, with infectious intracranial aneurysms rarely accounting for approximately 0.7% of all aneurysms. This condition tends to occur in younger men than in those who develop degenerative aneurysms. 4 – 6 These aneurysms grow rapidly and have high chances of rupture, with an increase in mortality of up to 60%. 7 The location and time of the survey impact pathogen identification in cases of mycotic thoracic aortic aneurysm (MTAA), which can vary significantly. Before the advent of antibiotics, gram-positive cocci, such as Staphylococcus and Streptococcus , were commonly implicated in endocarditis. However, in the last two decades, gram-negative organisms have emerged more prominently, accounting for up to 40% of MTAA cases. Among them, the most prevalent pathogens are Staphylococcus spp, Streptococcus spp , and nontyphoidal Salmonella species. In Western countries, Staphylococcus aureus (28%), Salmonella spp. (15%), and Pseudomonas aeruginosa (10%) are the most common causative organisms. In contrast to Asian countries, Salmonella remains the predominant pathogen, of which non typhoidal Salmonella such as Salmonella typhimurium , S. e nteritidis (serogroup D), and S. choleraesuis (serogroup C) are the most frequently isolated species. Additionally, other gram-positive bacteria (e.g ., Clostridium, Corynebacterium, Enterococci ), gram-negative bacteria (e.g., E. coli, Enterobacter, Serratia, Haemophilus influenzae, Proteus vulgaris, Yersinia enterocolitica, Burkholderia pseudomallei, Klebsiella pneumoniae, Coxiella burnetii, Campylobacter ), and anaerobic organisms (e.g., Bacteroides fragilis ), as well as less common but notable pathogens such as Treponema pallidum and Mycobacterium tuberculosis , may contribute to the pathogenesis of MTAA. 8 The semiautomated Vitek 2 system contributes to approximately 50% to 85% of the diagnoses of etiology from blood cultures, which are positive in patients with a mycotic aneurysm. Majority of cases typically involve a single organism that is isolated, although multiple organisms can be found in 8% of cases, followed by 25% of cases where the etiology is unknown. The most identified pathogens include nontyphoid Salmonella, Staphylococcus, Campylobacter, and Streptococcus, but E. coli, Mycobacteria, and Bacteroides species have also been reported. Identifying infective microorganisms and confirming their antibiotic sensitivity can aid in the administration of targeted antimicrobial selection. However, bacterial isolation may be challenging due to culture difficulties or prior antibiotic treatment. Molecular methods such as multiplex polymerase chain reaction (PCR) can improve organism identification from blood cultures. 3 A study by Alawieh et al reported that 44.2% of IIAs were small in size (<5 mm), 56.9% were traced in the MCA, and 13.1% were traced in the PCA. 9 Prompt recognition of these cases is an effective tool for the management of postinfectious aneurysms. Timely diagnosis of a mycotic TAAA requires a high index of suspicion in patients presenting with fever, headache, back pain, pain abdomen, or a pulsatile abdominal mass. 4 , 10 In our study, TAAA patients presented with similar symptoms, namely, acute onset of fever and abdominal pain followed by hypovolemic shock. Although leucocytosis and elevated erythrocyte sedimentation rates are common, these findings are nonspecific and can often lead to delayed or incorrect diagnoses. Many a times blood cultures may be negative for bacteraemia, especially if there is before antibiotic administration. Contrast-enhanced computed tomography can suggest infective features, such as an atypical setting of the aneurysm; a multilobulated, multifocal or saccular configuration; lacking calcification in the aneurysmal wall; gas in the periaortic area with a soft tissue reaction; and adjacent vertebral osteomyelitis. In uncertain cases, Gallium-67 isotope scanning may help in localizing the active infectious process and with a hold on septic foci at other site. Angiography, when feasible, is useful tool for defining the anatomy of the visceral vessels and aiding in preoperative planning. Even if noninvasive tests are negative, DSA remains the yardstick and is recommended for the detection of IIAs. 11 , 12 Some patients in our series were initially treated for conditions such as acute pyelonephritis, presenting typically with fever, flank pain, and on kidney echography, or spinal osteomyelitis showing hydronephrosis, presenting with fever, malaise, and back pain in bedridden patients before the right diagnosis of an infectious aneurysm was made. 13 In patients with ruptured IIAs and intra-abdominal aneurysms or in those who fail conservative therapy, endovascular intervention is the mainstay in comparison with microsurgical craniotomies as it offers significantly lower mortality, better accessibility to distal aneurysms, superior outcomes in the treatment of multiple aneurysms, patients with comorbidities, and a decreased risk of anticoagulation. 9 Endovascular intervention was performed with stent graft placement for intra-abdominal aneurysms. Embolization with liquid agents such as glue and/or coils was considered for pulmonary artery or intracranial aneurysms. The placement of coils to obliterate the aneurysm was also considered for intracranial aneurysms. The role of surgical intervention should be considered in cases involving large intraparenchymal hematomas or significant cerebral edema or when revascularization is needed. Administration of intravenous post op antibiotics in the hospital for at least 4 weeks guided by clinical and laboratory parameter normalization. 7 Conclusion Mycotic aneurysms (MAs) present significant clinical challenges because of their rare occurrence and the complexities involved in their diagnosis and management. A high index of suspicion for MAs should be maintained in patients with fever, elevated inflammatory markers such as C-reactive protein and ESR, and sudden development of atypical aneurysms. Prompt blood culture and appropriate imaging are crucial for timely diagnosis. Effective management also includes a comprehensive laboratory workup and imaging studies to guide treatment decisions and monitor progress. The management of MAs requires a multifaceted approach that combines surgical and medical interventions. Surgical options include clipping or clamping with reconstruction and graft placement, whereas endovascular treatments are reserved for hemodynamically unstable or medically fragile patients. Postoperative care involves prolonged antibiotic therapy to ensure infection resolution and prevent recurrence. Ultimately, this study underscores the necessity of early and definitive surgical or endovascular intervention under antibiotic coverage to improve outcomes and reduce the risk of aneurysm re-rupture. Data availability statement The authors confirm that the data supporting the findings of this study are available within the article. References 1. Grandhi R, Zwagerman NT, Linares G, et al. : Onyx embolization of infectious intracranial aneurysms. J. Neurointerv. Surg. 2014; 6 (5): 353–356. PubMed Abstract | Publisher Full Text 2. Calderón-Parra J, Domínguez F, González-Rico C, et al. : Epidemiology and Risk Factors of Mycotic Aneurysm in Patients with Infective Endocarditis and the Impact of its Rupture in Outcomes. Analysis of a National Prospective Cohort. Open Forum Infect. Dis. 2024 Mar 13; 11 (3): ofae121. PubMed Abstract | Publisher Full Text | Free Full Text 3. Osler W: The gulstonian lectures, on malignant endocarditis. Br. Med. J. 1885; 1 (1262): 467–470. PubMed Abstract | Publisher Full Text | Free Full Text 4. Deipolyi AR, Czaplicki CD, Oklu R: Inflammatory and infectious aortic diseases. Cardiovasc. Diagn. Ther. 2018; 8 (Suppl 1): S61–S70. PubMed Abstract | Publisher Full Text | Free Full Text 5. Wilson WR, Bower TC, Creager MA, et al. : Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: a scientific statement from the American Heart Association. Circulation. 2016; 134 (20): e412–e460. PubMed Abstract | Publisher Full Text 6. Ando K, Hasegawa H, Kikuchi B, et al. : Treatment Strategies for Infectious Intracranial Aneurysms: Report of Three Cases and Review of the Literature. Neurol. Med. Chir. (Tokyo). 2019 Sep 15; 59 (9): 344–350. Epub 2019 Jul 4. PubMed Abstract | Publisher Full Text | Free Full Text 7. Dsouza R, Kota AA, Jain S, et al. : Mycotic abdominal aortic aneurysm complicated by infective spondylitis due to Pseudomonas aeruginosa. BMJ Case Rep. 2020; 13 (2): 1–3. PubMed Abstract | Publisher Full Text | Free Full Text 8. Raavi L, Garg P, Hussain MWA, et al. : Mycotic Thoracic Aortic Aneurysm: Epidemiology, Pathophysiology, Diagnosis, and Management. Cureus. 14 (11): e31010. 9. Alawieh A, Chaudry MI, Turner RD, et al. : Infectious intracranial aneurysms: a systematic review of epidemiology, management, and outcomes. J. Neurointerv. Surg. 2018; 10 : 708–716. PubMed Abstract | Publisher Full Text 10. Guo Y, Bai Y, Yang C, et al. : Mycotic aneurysm due to Salmonella species: clinical experiences and review of the literature. Braz. J. Med. Biol. Res. 2018; 51 (9): e6864. PubMed Abstract | Publisher Full Text | Free Full Text 11. Cinà CS, Arena GO, Fiture AO, et al. : Ruptured mycotic thoracoabdominal aortic aneurysms: A report of three cases and a systematic review. J. Vasc. Surg. 2001 Apr 1; 33 (4): 861–867. PubMed Abstract | Publisher Full Text 12. Huang YK, Chen CL, Lu MS, et al. : Clinical, Microbiologic, and Outcome Analysis of Mycotic Aortic Aneurysm: The Role of Endovascular Repair. Surg. Infect. 2014 Jun 1; 15 (3): 290–298. PubMed Abstract | Publisher Full Text | Free Full Text 13. Aoki C, Fukuda W, Kondo N, et al. : Surgical Management of Mycotic Aortic Aneurysms. Ann. Vasc. Dis. 2017 Mar 24; 10 (1): 29–35. PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 03 Dec 2025 ADD YOUR COMMENT Comment Author details Author details 1 Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India Keerthiraj B Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Bergin C Roles: Data Curation, Formal Analysis, Investigation, Methodology, Resources, Validation, Writing – Original Draft Preparation Pooja Rao Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Udayalaxmi Jeppu Roles: Formal Analysis, Investigation, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 03 Dec 2025, 14:1356 https://doi.org/10.12688/f1000research.171966.1 Copyright © 2025 B K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article B K, C B, Rao P and Jeppu U. Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] . F1000Research 2025, 14 :1356 ( https://doi.org/10.12688/f1000research.171966.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 03 Dec 2025 Views 0 Cite How to cite this report: Sinha R. Reviewer Report For: Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] . F1000Research 2025, 14 :1356 ( https://doi.org/10.5256/f1000research.189639.r439175 ) The direct URL for this report is: https://f1000research.com/articles/14-1356/v1#referee-response-439175 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 30 Dec 2025 Richa Sinha , Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; Microbiology, Dr.Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Lucknow, Uttar Pradesh, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.189639.r439175 This article provides crucial, region-specific data on infectious aneurysm highlighting their diverse causes (like Salmonella , E. coli , fungi) in Indian patients. The author have well mentioned the details of 11 retrospective cases of infectious aneurysms (IA), and have highlighted high ... Continue reading READ ALL This article provides crucial, region-specific data on infectious aneurysm highlighting their diverse causes (like Salmonella , E. coli , fungi) in Indian patients. The author have well mentioned the details of 11 retrospective cases of infectious aneurysms (IA), and have highlighted high mortality in high-risk patients (hypertension, diabetes). This article gives emphasises on open surgery over EVAR for better infection clearance, and recommends post-surgery IV antibiotics to prevent recurrence. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Infectious disease , Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sinha R. Reviewer Report For: Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] . F1000Research 2025, 14 :1356 ( https://doi.org/10.5256/f1000research.189639.r439175 ) The direct URL for this report is: https://f1000research.com/articles/14-1356/v1#referee-response-439175 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 03 Dec 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 03 Dec 25 read Richa Sinha , Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India; Dr.Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Lucknow, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Sinha R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 30 Dec 2025 | for Version 1 Richa Sinha , Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; Microbiology, Dr.Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Lucknow, Uttar Pradesh, India 0 Views copyright © 2026 Sinha R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This article provides crucial, region-specific data on infectious aneurysm highlighting their diverse causes (like Salmonella , E. coli , fungi) in Indian patients. The author have well mentioned the details of 11 retrospective cases of infectious aneurysms (IA), and have highlighted high mortality in high-risk patients (hypertension, diabetes). This article gives emphasises on open surgery over EVAR for better infection clearance, and recommends post-surgery IV antibiotics to prevent recurrence. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Infectious disease , Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Sinha R. Peer Review Report For: Exploring infectious aneurysms through a series of cases in a tertiary care unit in South India [version 1; peer review: 1 approved] . F1000Research 2025, 14 :1356 ( https://doi.org/10.5256/f1000research.189639.r439175) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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