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Aspergillus thromboembolism from a mycotic ascending aortic pseudoaneurysm

Afshin A Skibba1, Michael R West1, James R Evans1

  • 1Division of Vascular Surgery, East Tennessee State University, Johnson City, Tenn.

Journal of Vascular Surgery Cases
|November 15, 2019
PubMed

Insights

This case report highlights a rare cause of acute limb ischemia: a fungal infection of the aorta. Early diagnosis of mycotic aneurysms is crucial for effective treatment.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Acute limb ischemia can stem from various causes, including thromboembolism.
  • Mycotic aneurysms, particularly those involving the aorta, are uncommon but serious conditions.
  • Fungal infections can lead to the formation of pseudoaneurysms and subsequent embolic events.

Purpose of the Study:

  • To report a case of acute upper extremity ischemia secondary to an Aspergillus-infected ascending aortic pseudoaneurysm.
  • To emphasize the importance of considering mycotic infections in patients with unexplained thromboembolic events.
  • To highlight diagnostic strategies for identifying the source of arterial thromboembolism.

Main Methods:

  • Case presentation of an immune-competent patient with acute arterial thromboembolism.
  • Review of diagnostic workup including imaging and laboratory tests.
  • Pathologic examination of embolic material.

Main Results:

  • Identification of an Aspergillus-infected ascending aortic pseudoaneurysm as the source of thromboembolism.
  • The patient presented with acute upper extremity ischemia.
  • Diagnostic measures confirmed the fungal etiology.

Conclusions:

  • Ascending aortic pseudoaneurysms infected by Aspergillus can cause acute limb ischemia.
  • A high index of suspicion for mycotic infections is warranted in atypical thromboembolic presentations.
  • Comprehensive diagnostic approaches, including pathological examination and advanced imaging, are vital for etiological determination.

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