IMAGES IN CARDIO-THORACIC SURGERY
European Journal of Cardio-Thoracic Surgery 47 (2015) e233–e234 doi:10.1093/ejcts/ezv092 Advance Access publication 1 March 2015
Cite this article as: Nicolini F, Budillon AM, Borrello B, Gherli T. Ascending aortic graft thrombosis from an endoluminal candida albicans infection. Eur J Cardiothorac Surg 2015;47:e233–e4.
Ascending aortic graft thrombosis from an endoluminal candida albicans infection Francesco Nicolinia,*, Alessandro Maria Budillonb, Bruno Borrellob and Tiziano Gherlia a b
Department of Clinical and Experimental Medicine, Cardiac Surgery Section, University of Parma, Parma, Italy Cardiac Surgery Department, Parma Hospital, Parma, Italy
* Corresponding author. Department of Clinical and Experimental Medicine, Cardiac Surgery Section, University of Parma, Via A. Gramsci 14, Parma 43126, Italy. Tel: +39-0521-703270; fax: +39-0521-702188; e-mail: [email protected] (F. Nicolini). Received 20 December 2014; received in revised form 31 January 2015; accepted 4 February 2015
Keywords: Fungal endocarditis • Thoracic aorta • Cardiac surgery
ACKNOWLEDGEMENTS We thank Lois Clegg for her assistance in the revision of the manuscript.
IMAGES IN CARDIOTHORACIC SURGERY
A 71-year old male who had undergone ascending aortic replacement because of intramural haematoma was referred with abdominal pain and fever. Computed tomography scan showed thrombosis circumferentially adhering to the Dacron graft (Fig. 1). After graft excision, cultures were positive for Candida albicans, a life-threatening condition rarely described in the literature.
© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
e234
F. Nicolini et al. / European Journal of Cardio-Thoracic Surgery
Figure 1: Chest computed tomography scans in (A) transverse view and (B) coronal view showing an occlusive thrombus in the aortic Dacron prosthesis (red arrows). Intraoperative view of the opened aortic graft (C) and the thrombus (fungal vegetation) attached to the Dacron prosthesis following surgical excision (D) (black arrows). The patient received a new 28-mm Dacron prosthesis (E), in the absence of any involvement of the native aortic valve. After aggressive antifungal therapy with fluconazole (400 mg iv/daily) and caspofungin (50 mg iv/daily), the in-hospital postoperative course was initially uneventful, but the patient died 3 months after surgery because of septic shock secondary to systemic candidiasis.
European Journal of Cardio-Thoracic Surgery 47 (2015) e233–e234 doi:10.1093/ejcts/ezv092 Advance Access publication 1 March 2015
Cite this article as: Nicolini F, Budillon AM, Borrello B, Gherli T. Ascending aortic graft thrombosis from an endoluminal candida albicans infection. Eur J Cardiothorac Surg 2015;47:e233–e4.
Ascending aortic graft thrombosis from an endoluminal candida albicans infection Francesco Nicolinia,*, Alessandro Maria Budillonb, Bruno Borrellob and Tiziano Gherlia a b
Department of Clinical and Experimental Medicine, Cardiac Surgery Section, University of Parma, Parma, Italy Cardiac Surgery Department, Parma Hospital, Parma, Italy
* Corresponding author. Department of Clinical and Experimental Medicine, Cardiac Surgery Section, University of Parma, Via A. Gramsci 14, Parma 43126, Italy. Tel: +39-0521-703270; fax: +39-0521-702188; e-mail: [email protected] (F. Nicolini). Received 20 December 2014; received in revised form 31 January 2015; accepted 4 February 2015
Keywords: Fungal endocarditis • Thoracic aorta • Cardiac surgery
ACKNOWLEDGEMENTS We thank Lois Clegg for her assistance in the revision of the manuscript.
IMAGES IN CARDIOTHORACIC SURGERY
A 71-year old male who had undergone ascending aortic replacement because of intramural haematoma was referred with abdominal pain and fever. Computed tomography scan showed thrombosis circumferentially adhering to the Dacron graft (Fig. 1). After graft excision, cultures were positive for Candida albicans, a life-threatening condition rarely described in the literature.
© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
e234
F. Nicolini et al. / European Journal of Cardio-Thoracic Surgery
Figure 1: Chest computed tomography scans in (A) transverse view and (B) coronal view showing an occlusive thrombus in the aortic Dacron prosthesis (red arrows). Intraoperative view of the opened aortic graft (C) and the thrombus (fungal vegetation) attached to the Dacron prosthesis following surgical excision (D) (black arrows). The patient received a new 28-mm Dacron prosthesis (E), in the absence of any involvement of the native aortic valve. After aggressive antifungal therapy with fluconazole (400 mg iv/daily) and caspofungin (50 mg iv/daily), the in-hospital postoperative course was initially uneventful, but the patient died 3 months after surgery because of septic shock secondary to systemic candidiasis.
