A rare case of peripheral vascular graft infection by Aspergillus fumigatus and review of the literature

Abstract

We present an unusual case of a 74-year-old woman who presented with a pseudoaneurysm at the site of a previous prosthetic femoro-popliteal bypass graft and underwent an urgent repair with pseudoaneurysm excision and extra-anatomic placement of an autologous venous graft. Microbiology examination revealed Aspergillus fumigatus infection of the graft, which is a very rare condition. Long-term antifungal medication has been administrated with positive outcome. Only a few cases have been reported in literature, mainly involving aortic grafts. Most patients are immunocompetent and with late presentation. Successful outcome can only be achieved with long-term antifungal treatment and extra-anatomic replacement of the graft.

A rare case of angioinvasive aspergillosis aortic graft infection causing peripheral thromboembolism

“… 1 , 2 , 3 , 4 Infection was identified a median of 8 months (range, 1-39 months) after graft implantation. 5 , 6 Most of these patients had Dacron or polytetrafluoroethylene prosthetic grafts. 2 Graft contamination is thought to be secondary to airborne fungal contamination during graft implantation.…”

“…Reported complications related to aspergillosis graft infections include pseudoaneurysm, vertebral osteomyelitis, and, most commonly, thromboembolism. 2 , 4 , 5 , 6 …”

“…Improved survival of patients with angioinvasive aspergillosis has been seen with complete graft excision and extra-anatomic bypass. 2 , 6 In addition, prolonged treatment with antifungal agents is essential.…”