A Case of Vascular Graft Infection by Aspergillus Causing Distal Embolism to the Foot

(Department of Cardiovascular Surgery, NTT Higashi Nihon, Sapporo Hospital, Sapporo, Japan)

Kenji Matsuzaki Ko Takigami Hiroshi Matsuura
A 77-year-old woman with previous aortic grafting for abdominal aortic and iliac artery aneurysms developed a blue toe in her left foot. Enhanced CT showed a high density area around the vascular graft of the left iliac artery, which partially protruded into the graft. Because of the elevated β-D glucan level, fungal infection of the vascular graft was strongly suspected. Her general condition precluded the graft removal. Instead, thrombectomy was performed. Microbial examination of the removed clot revealed infection by Aspergillus fumigatus. Voriconazole was administered for 3 months. The β-D glucan level was normalized. Only thrombectomy and Voriconazole administration can be an alternative in case with vascular graft infection by Aspergillus.
   Jpn. J. Cardiovasc. Surg. 43:5-8(2014)

Keywords:Aspergillus;prosthetic graft infection;voriconazole