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Fungal Ball in Ascending Aorta: Disseminated Histoplasmosis 20 Years After Aneurysm Repair

Defne Güneş Ergi1, Crystal R Bonnichsen2, Alberto Pochettino1

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.

Annals of Thoracic Surgery Short Reports
|January 10, 2025
PubMed

Insights

Disseminated histoplasmosis, a fungal infection, can affect aortic grafts years after surgery. Early antifungal treatment and surgical repair are crucial for successful outcomes in complex cases.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Cardiovascular Surgery

Background:

  • Histoplasma capsulatum causes histoplasmosis, a fungal infection.
  • Disseminated histoplasmosis is rare, affecting about 1% of infected individuals.
  • Endovascular graft infections, especially on aortic grafts, are a known complication.

Observation:

  • A 73-year-old male presented with disseminated histoplasmosis.
  • The infection manifested two decades after ascending aortic aneurysm repair.
  • A fungal ball was found in the proximal ascending aorta.

Findings:

  • The patient had a fungal ball in the ascending aorta.
  • Successful treatment involved aortic root replacement and hemiarch reconstruction.
  • This case highlights a rare late complication of aortic aneurysm repair.

Implications:

  • Prompt diagnosis and combined antifungal and surgical treatment are essential.
  • This case underscores the importance of considering fungal infections in late graft complications.
  • Surgical intervention in conjunction with antifungal therapy offers a favorable prognosis.

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