Mycotic aneurysm of the distal aortic arch caused by Aspergillus.
We describe an unusual case of a thoracic aortic aneurysm caused by Aspergillus. 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.
Hosono
Mitsuharu
M
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hattori
Koji
K
Shibata
Toshihiko
T
Sasaki
Yasuyuki
Y
Hirai
Hidekazu
H
Suehiro
Shigefumi
S
D000368:Aged; D000785:Aneurysm, Infected / Q000209:etiology* / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D000935:Antifungal Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology* / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D001228:Aspergillosis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D010198:Pancytopenia / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D003561:Cytarabine; D011239:Prednisolone