title: Suprainguinal vascular pythiosis: effective long-term outcome of aggressive surgical eradication.
abstract: Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum, has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thalassemic patient who presented with a right inflammatory pulsatile groin mass and right limb ischemia. The computerized tomography angiography indicated a false aneurysm at the right external iliac artery and thrombosed entire right leg arteries. The management comprised antifungal agent, immunotherapy, and surgical removal of all infected arteries (high up to the right common iliac artery and above-knee amputation). The patient was found in a good condition at 36 months after the follow-up period.
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: khanitis@gmail.com.
authors.forename: Suteekhanit
authors.initials: S
authors.lastname: Hahtapornsawan
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chumpol
authors.initials: C
authors.lastname: Wongwanit
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Khamin
authors.initials: K
authors.lastname: Chinsakchai
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kiatisak
authors.initials: K
authors.lastname: Hongku
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Nuttawut
authors.initials: N
authors.lastname: Sermsathanasawadi
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chanean
authors.initials: C
authors.lastname: Ruangsetakit
authors.affiliation: Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pramook
authors.initials: P
authors.lastname: Mutirangura
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D000935:Antifungal Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006119:Groin / Q000098:blood supply* / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D058968:Pythiosis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000935:Antifungal Agents