Korean J Med.
2009 Apr;76(Suppl 1):S70-S75.
A case of metastatic mycotic pseudoaneurysms that developed after aortic surgery
- Affiliations
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- 1Department of Internal Medicine, Vision21 Cardiac and Vascular Center, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. djh95@hanmail.net
- 2Department of Chest Surgery, Vision21 Cardiac and Vascular Center, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
- 3Department of Pathology, Vision21 Cardiac and Vascular Center, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Abstract
- Multiple mycotic pseudoaneurysms that develop after aortic surgery are a rare infectious complication. The clinical course of this disease is severe and associated with a high mortality. Few published cases have described mycotic pseudoaneurysms that are localized mainly in the brain, heart, and aorta. In this case, a 33-year-old woman was admitted with abdominal pain and mild fever after graft surgery for a ruptured thoracic aorta that occurred following a vehicle accident. Thoracoabdominal computed tomography (CT), angiography, and transesophageal echocardiography (TEE) demonstrated multiple pseudoaneurysms and thromboembolic obstructions in the thoracic aorta and its branches. She was treated with anticoagulation, coil embolization, and surgical resection. Microscopically, a resected pseudoaneurysm showed the characteristic features of fungal colonies with thrombi. This patient has been well for 2 months after removing the pseudoaneurysms and treatment with systemic antifungal agents.