Skip to main content
Log in

Mycotic aneurysm of the distal aortic arch caused byAspergillus

  • Case Report
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

We describe an unusual case of a thoracic aortic aneurysm caused byAspergillus. A 70-year-old man underwent prednisolone and Ara-C treatments for a myelodysplastic syndrome. Blood examination revealed pancytopenia. Under these treatments, an aneurysm presented at the distal aortic arch. He underwent resection of the aneurysm with a graft repair covered by a pedicled omentum flap, followed by prolonged administration of micafungin and itraconazole for a mycotic aneurysm. The postoperative course was favorable without complications. Serum C-reactive protein became negative and he was discharged 2 months after the surgery. However, 4 months after the surgery, he died from worsening of the myelodysplastic syndrome. The prognosis for patients with mycotic aneurysms is poor due to their immunocompetent condition arising from underlying diseases. Therefore, in addition to prompt treatment with antifungal agents combined with surgical debridement, control of the underlying disease is essential for improving the outcome. (Jpn J Thorac Cardiovasc Surg 2006; 54:160-163)

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Wells WJ, Fox AH, Theodore PR, Ross LA, Stanley P, Starnes VA. Aspergillosis of the posterior mediastinum. Ann Thorac Surg 1994; 57: 1240–3.

    Article  CAS  PubMed  Google Scholar 

  2. Silva ME, Malogolowkin MH, Hall TR, Sadeghi AM, Krogstad P. Mycotic aneurysm of the thoracic aorta due to Aspergillus terreus: Case report and review. Clin Infect Dis 2000; 31:1144–8.

    Article  CAS  PubMed  Google Scholar 

  3. Hasegawa T, Tsukube T, Higuma T, Okita Y. Successful replacement of aortic root with valvesparing technique and proximal arch in a patient with myelodysplastic syndrome. Jpn J Thorac Cardiovasc Surg 2003; 51: 322–5.

    Article  PubMed  Google Scholar 

  4. Yoshida Y, Hirashima K, Asano S, Takaku F. A phase II trial of recombinant human granulocyte colony-stimulating factor in the myelodysplastic syndromes. Br J Haematol 1991; 78: 378–84.

    Article  CAS  PubMed  Google Scholar 

  5. McHenry MC, Rehm SJ, Krajewski LP, Duchesneau PM, Levin HS, Steinmuller DR. Vertebral osteomyelitis and aortic lesions: Case report and review. Rev Infect Dis l991;13: 1184–94.

    Article  CAS  PubMed  Google Scholar 

  6. Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams TW Jr. In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg 1989; 47: 193–203.

    Article  CAS  PubMed  Google Scholar 

  7. Coselli JS, Crawford ES, Williams TW Jr, Bradshaw MW, Wiemer DR, Harris RL, et al. Treatment of postoperative infection of ascending aorta and transverse aortic arch, including use of viable omentum and muscle flaps. Ann Thorac Surg 1990; 50: 868–81.

    Article  CAS  PubMed  Google Scholar 

  8. Fromtling RA. Micafungin sodium (FK-463). Drugs Today 2002; 38: 245–57.

    Article  CAS  PubMed  Google Scholar 

  9. Yokote T, Akioka T, Oka S, Fujisaka T, Yamano T, Hara S, et al. Successful treatment with micafungin of invasive pulmonary aspergillosis in acute myeloid leukemia, with renal failure due to amphotericin B therapy. Ann Hematol 2004; 83: 64–6.

    Article  CAS  PubMed  Google Scholar 

  10. Denning DW, Lee JY, Hostetler JS, Pappas P, Kauffman CA, Dewsnup DH, et al. NIAID Mycoses Study Group Multicenter Trial of Oral Itraconazole Therapy for Invasive Aspergillosis. Am J Med 1994; 97: 135–44.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hosono, M., Hattori, K., Shibata, T. et al. Mycotic aneurysm of the distal aortic arch caused byAspergillus . Jpn J Thorac Caridovasc Surg 54, 160–163 (2006). https://doi.org/10.1007/BF02662471

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02662471

Key word

Navigation