PMID- 35365071
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20220510
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Apr 1
TI  - Case report: Vascular graft infection due to Aspergillus species presenting with 
      recurrent vascular occlusion.
PG  - 138
LID - 10.1186/s12872-022-02571-3 [doi]
LID - 138
AB  - BACKGROUND: An aortic graft implantation is an effective therapeutic method for 
      various aortic diseases. However, it is known that sometimes these implanted 
      grafts can be the foci of infections. Here we report a rare case of graft 
      infection that presented multiple embolisms of aortic branches and peripheral 
      organs. CASE PRESENTATION: A 63-year-old Japanese woman with a history of aortic 
      graft implantation presented with occlusions of large arteries in different loci 
      and time points, with elevation of non-specific inflammatory markers. Thoracic 
      contrast-computed tomography (CT) captured vegetation in the descending aortic 
      graft and the [18F]fluorodeoxyglucose positron emission tomography/computed 
      tomography ([18F]FDG PET/CT) showed accumulation of FDG in the same site, 
      suggesting a graft infection. Despite all these suspicious findings, repeated 
      blood culture examinations never detected any microorganisms. A diagnosis of 
      Aspergillus graft infection was made based on an elevated serum beta-D glucan (betaDG) 
      and a positive Aspergillus galactomannan (GM) antigen test. The patient 
      subsequently had surgery with replacement of the descending aortic graft and 
      anti-fungal drugs were instituted with significant improvement noted. CONCLUSION: 
      In the present case, the patient's specific feature in the anatomical vascular 
      construction, past operation, and basal fundamental diseases collaboratively 
      contributed to the pathogenesis of the present infection. It is important to 
      recognize the risk of graft infection and conduct imaging studies when indicative 
      symptoms emerge. The negativity in blood culture studies often makes detection of 
      pathogenic microbes extremely difficult. This case suggests that non-cultural 
      tests such as bDG and GM can be useful for diagnosis and starting appropriate 
      anti-fungal drugs in the early stages.
CI  - (c) 2022. The Author(s).
FAU - Tano, Ayami
AU  - Tano A
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Kato, Koichi
AU  - Kato K
AUID- ORCID: 0000-0002-6125-0789
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan. kou1kato@belle.shiga-med.ac.jp.
FAU - Seike, Yoshimasa
AU  - Seike Y
AD  - Department of Cardiovascular Surgery, National Cerebral and Cardiovascular 
      Center, Suita, Japan.
FAU - Matsuda, Hitoshi
AU  - Matsuda H
AD  - Department of Cardiovascular Surgery, National Cerebral and Cardiovascular 
      Center, Suita, Japan.
FAU - Suzue, Takashi
AU  - Suzue T
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Kaneko, Yoshihiro
AU  - Kaneko Y
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Kodama, Misato
AU  - Kodama M
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Sawayama, Yuichi
AU  - Sawayama Y
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Miyamoto, Akashi
AU  - Miyamoto A
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Yagi, Noriaki
AU  - Yagi N
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
FAU - Nakagawa, Yoshihisa
AU  - Nakagawa Y
AD  - Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, 
      Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220401
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
RN  - 0 (Radiopharmaceuticals)
SB  - IM
MH  - Aspergillus
MH  - Blood Vessel Prosthesis/adverse effects
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - *Positron Emission Tomography Computed Tomography/methods
MH  - *Prosthesis-Related Infections/diagnostic imaging/surgery
MH  - Radiopharmaceuticals
PMC - PMC8974158
OTO - NOTNLM
OT  - Aspergillus
OT  - Aspergillus galactomannan antigen test
OT  - Embolism
OT  - Graft infection
OT  - Non-cultural study
OT  - [18F]fluorodeoxyglucose positron emission tomography/computed tomography
OT  - beta-D glucan
COIS- The authors have no competing interests.
EDAT- 2022/04/03 06:00
MHDA- 2022/04/06 06:00
PMCR- 2022/04/01
CRDT- 2022/04/02 05:21
PHST- 2021/12/20 00:00 [received]
PHST- 2022/03/18 00:00 [accepted]
PHST- 2022/04/02 05:21 [entrez]
PHST- 2022/04/03 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 10.1186/s12872-022-02571-3 [pii]
AID - 2571 [pii]
AID - 10.1186/s12872-022-02571-3 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2022 Apr 1;22(1):138. doi: 10.1186/s12872-022-02571-3.