title: GRAFT infection of thoracic aorta due to group C beta-hemolytic streptococcus--a case report.
abstract: A fatal case of late-onset graft infection of the thoracic aorta due to group C beta-hemolytic streptococcus is described. A 37-year-old male patient, who had a history of total aortic arch replacement for acute aortic dissection 8 years before, was admitted to the department. He suffered from toxic shock syndrome, disseminated intravascular coagulation (DIC), and acute renal failure. Group C beta-hemolytic streptococcus was detected from his blood; however, echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) failed to detect the focus of the infection. In spite of intensive care, including antibiotic therapy, artificial ventilation, and continuous hemodiafiltration, he died on the 18th day of hospitalization. Autopsy revealed that a small abscess was present at the proximal anastomotic segments of the patient's graft. A bite inflicted by his dog, 14 days before admission, was suspected to be the source of this bacterium. A rare case of graft infection of thoracic aorta in terms of causative organism, long period from graft replacement to graft infection, and site of infection is presented and discussed.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Fujisaki
authors.forename: Masaki
authors.initials: M
authors.lastname: Gushima
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Matsumura
authors.forename: Koji
authors.initials: K
authors.lastname: Fujii
authors.forename: Takuya
authors.initials: T
authors.lastname: Tsuchihashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirakata
authors.forename: Takashi
authors.initials: T
authors.lastname: Eguchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Moroi
authors.forename: Masutaka
authors.initials: M
authors.lastname: Furue
authors.forename: Hisataka
authors.initials: H
authors.lastname: Yasui
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000038:Abscess / Q000473:pathology; D000328:Adult; D000714:Anastomosis, Surgical; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery*; D000818:Animals; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D001025:Aortitis / Q000473:pathology*; D001733:Bites and Stings / Q000150:complications; D019917:Blood Vessel Prosthesis Implantation; D004211:Disseminated Intravascular Coagulation / Q000473:pathology; D004285:Dogs; D005205:Fascia / Q000473:pathology; D019115:Fasciitis, Necrotizing / Q000473:pathology*; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000473:pathology; D016459:Prosthesis-Related Infections / Q000473:pathology*; D012772:Shock, Septic / Q000473:pathology*; D013290:Streptococcal Infections / Q000473:pathology*; D013530:Surgical Wound Infection / Q000473:pathology*