Aortic Graft Infection With Mycobacterium Avium Complex

Area of Science:

• Infectious Diseases
• Cardiovascular Surgery
• Immunology

Background:

• Aortic graft infections are rare but serious complications following endovascular aortic surgery.
• Typically, gram-positive and gram-negative bacteria cause these infections.
• Atypical organisms are seldom implicated in graft infections, particularly in immunocompromised patients.

Observation:

• This report details a case of Mycobacterium avium complex (MAC) infection confirmed by culture in an aortic graft.
• The patient was diagnosed with well-controlled Human Immunodeficiency Virus (HIV).
• The patient maintained an undetectable viral load and a CD4 count of 324 cells/mm³ while on highly active antiretroviral therapy (HAART).

Findings:

• Culture-confirmed Mycobacterium avium complex infection of an aortic graft.
• Infection occurred in a patient with well-controlled HIV, demonstrating an atypical causative agent.
• The patient's immune status (CD4 count 324) did not preclude infection by an atypical organism.

Implications:

• This case expands the spectrum of pathogens responsible for aortic graft infections.
• It suggests that even well-controlled HIV patients may be susceptible to opportunistic infections like MAC affecting grafts.
• Clinicians should consider atypical organisms in the differential diagnosis of aortic graft infections, irrespective of perceived immune status.