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Histoplasmosis Infection of Aortobifemoral Graft Treated with a Neoaortoiliac System
Lisa F Bennett1, Andrea Klein1, Melissa Kirkwood1
1UT Southwestern Medical Center, Dallas, TX.
Abstract:
Aortic graft infections are a feared complication of aortic bypass operations and impart significant morbidity and mortality when they occur. The most common etiology is bacterial, with a presentation ranging from subclinical to acutely symptomatic depending on the organism. Fungal infections of prosthetic grafts are rare, especially in immunocompetent patients. Graft infections remain a clinical diagnosis. We report a rare case of an aortobifemoral graft infection with Histoplasma capsulatum that was diagnosed on surgical pathology, as the preoperative infectious evaluation was negative. The neoaortoiliac system operation was successfully used to solve this patient's highly morbid condition.
Insights
Fungal infections of aortic grafts are rare in immunocompetent patients. This case highlights Histoplasma capsulatum causing aortobifemoral graft infection, diagnosed via surgical pathology after negative tests.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Mycology
Background:
- Aortic graft infections are serious complications of bypass surgery, often bacterial.
- Fungal infections are uncommon, particularly in immunocompetent individuals.
Observation:
- A rare case of aortobifemoral graft infection caused by Histoplasma capsulatum is presented.
- The infection was diagnosed through surgical pathology, as initial infectious workup was negative.
Findings:
- Histoplasma capsulatum, a fungus, can cause prosthetic aortic graft infections.
- Surgical pathology is crucial for diagnosing rare graft infections when clinical and laboratory evaluations are inconclusive.
Implications:
- This case expands the understanding of fungal etiologies in aortic graft infections.
- Successful management involved the neoaortoiliac system, offering a solution for complex graft complications.
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