title: Aspergillus fumigatus vegetation of a prosthetic aortic root graft with mycotic aneurysm and subarachnoid hemorrhage.
abstract: A 58-year-old woman with a history of Bentall aortic graft and bioprosthetic aortic valve replacement 3 months prior to admission, presented with headache and fever. Imaging yielded a large obstructive filling defect in the ascending aorta, a subarachnoid hemorrhage, and a mycotic aneurysm. Intraoperative specimens grew Aspergillus fumigatus, and despite aggressive measures the patient died. Aspergillus infections of prosthetic vascular grafts are rare surgical complications and are difficult to diagnose given the low incidence of positive microbiology cultures and the long median time between surgery and diagnosis. Treatment has consisted of antifungal and surgical treatment, although mortality remains high.
authors: Division of Cardiology, Department of Medicine, UCLA Cardiovascular Center, University of California at Los Angeles Medical Center, 100 Medical Plaza, Suite 630, Los Angeles, CA 90095, USA.
authors: Jared
authors: J
authors: Oyama
authors: Linda
authors: L
authors: Zhou
authors: Seema A
authors: SA
authors: Mehta
authors: Anna R
authors: AR
authors: Laury
authors: John S
authors: JS
authors: Tsakonas
authors: Hillel
authors: H
authors: Laks
authors: Henry M
authors: HM
authors: Honda
authors: Eric H
authors: EH
authors: Yang
mesh_terms: D000785:Aneurysm, Infected / Q000150:complications* / Q000209:etiology*; D000790:Angiocardiography; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000637:transplantation; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000382:microbiology*; D006801:Humans; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000209:etiology*
keywords: Aortic root surgery; Aspergillus; Bentall graft; Extracorporeal membrane oxygenation; Shock (sepsis; Thrombosis; Vegetation; cardiogenic)