Multiple mycotic aneurysms and transverse myelopathy complicating repair of aortic coarctation

The case of an 18-year-old man with coarctation of the aorta discovered on routine physical examination and subsequently surgically repaired is reported. Four months postoperatively, aneurysms developed at the repair site and thrombosis of both femoral arteries was noted. Following an attempt to repair the aneurysm and remove the thrombi, the patient became paraplegic; Aspergillus fumigatus was found infecting the aorta and femoral vessels. After additional operations and a course of amphotericin B to control the fungal infection, the patient died of intrathoracic bleeding originating from infected, aneurysmally dilated intercostal vessels in the area of the original coarctation repair. The complicating fungal infection of the operative site and the paraplegia are discussed. This report is among the first to present a patient with fungal endarteritis complicating operation for coarctation of the aorta.