{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:52Z","timestamp":1786649812843,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>\n                    Infective endocarditis (IE) can lead to infectious intracranial aneurysms (IIAs) in a small percentage of cases. These aneurysms may rupture, resulting in intracerebral bleeding that is typically evident on neuroimaging. However, diagnosis becomes challenging when blood cultures and echocardiography are unremarkable, and neuroimaging is misinterpreted as a neoplasm due to overlapping features. We report a rare case of a ruptured IIA initially misdiagnosed as a brain tumor. A 43-year-old man presented with seizures, right-sided hemiparesis, and a 3-month history of fever, malaise, and 15-kg weight loss. Head computed tomography (CT) revealed a left frontal lesion with solid and hemorrhagic components, vasogenic edema, and intraventricular hemorrhage. Brain magnetic resonance imaging showed an enhancing mass-like lesion. Negative pan-cultures, normal echocardiography, and temporary improvement with oral prednisone led to a presumed diagnosis of brain tumor, and the patient was discharged for outpatient follow-up. Three months later, he was readmitted with persistent fever. This time,\n                    <jats:italic toggle=\"yes\">Streptococcus mutans<\/jats:italic>\n                    bacteremia and mitral valve vegetations confirmed IE. Brain CT angiography revealed multiple IIAs. He received intravenous antibiotics. His hospital course was complicated by decompensated heart failure and a myocardial infarction due to obstructive coronary artery disease, requiring mitral valve replacement and coronary artery bypass grafting. He was discharged hemodynamically stable. This case highlights that IIAs can closely mimic brain tumors on imaging. Clinicians should maintain a high index of suspicion for IE in patients with neurological symptoms and systemic signs of infection, even when initial diagnostic studies are inconclusive.\n                  <\/jats:p>","DOI":"10.4103\/heartviews.heartviews_115_25","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T13:00:32Z","timestamp":1763730032000},"page":"204-209","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ruptured Intracranial Infectious Aneurysm Mimicking an Expansive Brain Tumor in the Setting of Subacute Infective Endocarditis"],"prefix":"10.4103","volume":"26","author":[{"given":"Antony","family":"Gonzales-Uribe","sequence":"first","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Mes\u00eda","family":"Angeles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Alberto","family":"Espiche-Salazar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Barnabas Hospital, CUNY School of Medicine, The City University of New York, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar Simon","family":"Lagos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Cano","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e9lix Revilla","family":"Manchego","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mendoza-Quispe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Barnabas Hospital, CUNY School of Medicine, The City University of New York, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/nm1565","article-title":"Platelet TLR4 activates neutrophil extracellular traps to ensnare bacteria in septic blood","volume":"13","author":"Clark","year":"2007","journal-title":"Nat Med"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1161\/CIRCULATIONAHA.119.044913","article-title":"Incidence, microbiology, and outcomes in patients hospitalized with infective endocarditis","volume":"141","author":"Shah","year":"2020","journal-title":"Circulation"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"ofae121","DOI":"10.1093\/ofid\/ofae121","article-title":"Epidemiology and risk factors of mycotic aneurysm in patients with infective endocarditis and the impact of its rupture in outcomes. 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