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Arterial reconstruction for atypical mycotic aneurysms
Michael J Malinowski1, Pegge Halandras
1Loyola University Medical Center, Vascular Division, Maywood, IL 60153, USA. mmalinowski@lumc.edu
Vascular and Endovascular Surgery
|October 11, 2012
Summary
A lung transplant patient developed a femoral artery aneurysm and deep vein thrombosis after Pseudallescheria boydii infection. Cryoarterial reconstruction was necessary due to fungal recurrence, highlighting challenges in immunosuppressed patients.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Transplantation Medicine
Background:
- A 67-year-old male, post-lung transplantation for idiopathic pulmonary fibrosis, presented with septic arthritis.
- The infection was caused by the fungus Pseudallescheria boydii.
Observation:
- Following hip arthroplasty, the patient developed a 7-cm superficial femoral artery aneurysm with popliteal vein compression and deep venous thrombosis.
- Contralateral saphenous vein was unsuitable for arterial reconstruction.
Findings:
- Intraoperative arterial shunting and cryoarterial reconstruction were performed after aneurysm resection.
- Pseudallescheria boydii recurred in operative fungal cultures despite negative arterial wall cultures.
Implications:
- This case underscores the difficulties in achieving source control for fungal infections in immunosuppressed transplant recipients.
- Effective arterial reconstruction is complex in patients with challenging fungal pathogens and compromised immunity.
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