Aspergillus aortitis in a patient presenting with bilateral acute lower limb ischemia

Aspergillus niger aortitis is a rare but life-threatening fungal infection, typically affecting immunocompromised individuals. We present a unique case of a patient presenting with bilateral acute lower limb ischemia and a recent history of aortic valve repair. Despite the absence of typical infectious symptoms, further investigation revealed an infected floating thrombus in the ascending aorta. Subsequent surgical intervention and pathological analysis confirmed the presence of Aspergillus niger, a common environmental Mold, as the causative agent of aortitis. Our case highlights the challenges of diagnosing and managing Aspergillus niger aortitis, as symptoms can be subtle, and routine laboratory tests may not always detect the infection. Previous cardiac surgery is recognized as a significant risk factor for developing Aspergillus niger aortitis. This case report underscores the importance of considering Aspergillus niger aortitis in the differential diagnosis of patients with a history of cardiac surgery who present with unexplained embolic events, such as acute limb ischemia. Immediate recognition, decisive surgical intervention, and the initiation of appropriate antifungal therapy are imperative for maximizing patient outcomes in this complex condition.