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Cryptococcal aortitis presenting as a symptomatic abdominal aortic aneurysm.

Joseph Karam1, Athanasios Tsiouris2, Jose Vazquez3

  • 1Department of Vascular Surgery, Washington University, St. Louis, MO.

Annals of Vascular Surgery
|December 3, 2014
PubMed
Summary
This summary is machine-generated.

This study details a rare case of cryptococcal aortitis, a fungal infection of the aorta, presenting as a symptomatic abdominal aortic aneurysm (AAA). Early diagnosis and surgical intervention with antifungal therapy are crucial for managing this life-threatening condition.

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Area of Science:

  • Infectious Diseases
  • Cardiovascular Surgery
  • Mycology

Background:

  • Cryptococcal aortitis is a rare but severe fungal infection affecting the aorta.
  • Abdominal aortic aneurysms (AAAs) can rarely be caused by infections, termed mycotic aneurysms.
  • This case highlights a unique presentation of cryptococcal aortitis as a symptomatic AAA.

Observation:

  • A 59-year-old male presented with a symptomatic suprarenal abdominal aortic aneurysm (AAA).
  • Intraoperative findings included yeast organisms on Gram stain.
  • Postoperative cultures confirmed the presence of Cryptococcus neoformans.

Findings:

  • The patient underwent surgical repair of the AAA using a rifampin-soaked graft and omental wrapping.
  • Diagnosis of a true mycotic aneurysm was established intraoperatively.
  • Lifelong antifungal therapy was initiated due to the severity of the infection.

Implications:

  • This case represents the first reported instance of cryptococcal aortitis presenting as a symptomatic AAA.
  • Early recognition and aggressive management, including surgical repair and antifungal treatment, are vital.
  • Further research into the optimal management strategies for fungal aortitis is warranted.