A real mycotic aneurysm-mycotic aneurysm of the abdominal aorta due to fungal infection

Abstract

A 53-year-old male who was being followed up by a nephrology department because of type V crescentic glomerulonephritis was admitted with abdominal pain to our clinic. He was diagnosed with abdominal aortic aneurysm after the examinations. Aortic repair with a tubular graft was performed. Pathological examination of the aneurysm tissue showed fungal hyphae. We started antifungal chemotherapy with amphotericin B. A separation of the graft body occurred, and the patient was reoperated on. An excision of the graft, ligation of the aorta, and axillobifemoral graft by-pass was performed. At the 15 th month of his discharge, the patient was readmitted to the emergency room of our clinic suffering from hematemesis. According to the examinations, an aortoduodenal fistula was diagnosed, and we performed a partial duodenal resection and end-to-end duodenoduodenostomy. We want to share this unusual, interesting, and complicated case, operated on several times because of a mycotic aneurysm due to a fungal infection.

Treatment of a descending thoracic mycotic aneurysm secondary to disseminated aspergillosis infection with thoracic endovascular aortic repair

“… 7 , 8 , 9 Aspergillus MAAs occur after cardiac surgery, with infected valves and sutures, 10 , 11 , 12 , 13 and can be secondary to pyelonephritis or endocarditis. 14 , 15 , 16 Fungal MAAs can affect the aortic arch and the ascending, thoracic, and abdominal aortas. 7 , 12 , 15 , 16 , 17 , 18 Aspergillus infection will occur in 1% to 9% of liver transplant patients, with mortality >20%.…”

“… 14 , 15 , 16 Fungal MAAs can affect the aortic arch and the ascending, thoracic, and abdominal aortas. 7 , 12 , 15 , 16 , 17 , 18 Aspergillus infection will occur in 1% to 9% of liver transplant patients, with mortality >20%. The current guidelines have recommended prophylactic antifungal agents for high-risk transplant patients.…”

Glomerulonephritis triggered by chronical aortic graft infection in a male with Loeys–Dietz syndrome

“…[2,10] As the population ages and the number of aortic grafts placed increases, even with prophylactic antibiotics and low-infection rates, there will always be a small percentage of patients who develop aortic graft infections. Increased attention has been paid on glomerulonephritis caused by chronic low-grade infection of these “foreign bodies.” [11–13] The common pathogens include gram-positive organisms, that is, methicillin-resistant Staphylococcus aureus , and gram-negative infections such as P aeruginosa , which are more prone to formations of polysaccharide biofilms.…”

Infrarenal mycotic aortic pseudoaneurysm

“…He was educated and counseled to continue triple antiretroviral therapy. Follow up with vascular surgery in 2 weeks [4,5].…”