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GRAFT infection of thoracic aorta due to group C beta-hemolytic streptococcus--a case report

Hisatomi Arima1, Masaharu Nagata, Kiichiro Fujisaki

  • 1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Angiology
|March 29, 2005
PubMed

Insights

A rare late-onset thoracic aortic graft infection caused by group C beta-hemolytic streptococcus led to fatal toxic shock syndrome. Autopsy revealed a graft abscess, suspected from a dog bite, despite negative imaging.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Late-onset graft infections pose significant challenges in cardiovascular surgery.
  • Thoracic aortic graft infections are uncommon, especially with unusual pathogens.

Observation:

  • A 37-year-old male presented with toxic shock syndrome, disseminated intravascular coagulation, and acute renal failure 8 years post-aortic arch replacement.
  • Group C beta-hemolytic streptococcus was identified in blood, but imaging (echocardiography, CT, MRI) failed to locate the infection source.
  • A dog bite 14 days prior was the suspected inoculation event.

Findings:

  • Autopsy revealed a small abscess at the proximal anastomosis of the thoracic aortic graft.
  • The causative agent was identified as group C beta-hemolytic streptococcus.
  • Despite intensive care, the patient succumbed to the infection.

Implications:

  • This case highlights the possibility of late-onset, deep-seated graft infections from seemingly minor inoculation events.
  • It underscores the importance of considering unusual pathogens and subtle infection sites in graft complications.
  • The findings emphasize the need for vigilance in managing potential infection sources, even in long-term survivors of aortic surgery.

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