Multiple mycotic aneurysms with a rare fungus, Aspergillus niger: a complex case report

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Nephrology

Background:

• Mycotic aneurysms are rare arterial infections, historically misnamed by William Osler.
• They can affect any artery, with the aorta being most common, and are classified as primary, secondary, or cryptogenic.
• Fungal involvement is exceptionally rare, despite the term 'mycotic' implying fungal origin.

Observation:

• A young female patient with end-stage renal disease on peritoneal dialysis developed a mycotic aneurysm.
• The patient was treated with high-dose antifungal medication for Aspergillus niger infection.
• She transitioned to hemodialysis and was diagnosed with primary multiple mycotic aneurysms.

Findings:

• This case presents a rare instance of a fungal mycotic aneurysm in a patient with end-stage renal disease on peritoneal dialysis.
• The patient required a switch from peritoneal dialysis to hemodialysis due to the infection.
• Diagnosis revealed primary multiple mycotic aneurysms, indicating a complex clinical scenario.

Implications:

• Effective management of mycotic aneurysms requires a multidisciplinary approach involving medical, surgical, and nursing expertise.
• This case underscores the importance of considering fungal etiologies in mycotic aneurysms, especially in immunocompromised or dialysis patients.
• Optimal patient care involves tailored treatment strategies, including dialysis modality adjustments and aggressive antifungal therapy.