Mycotic aortic aneurysm in a debilitated patient with compromised immunity; beware of Candida!
Aneurisma micótico da aorta em paciente debilitado com imunidade comprometida – um alerta para Cândida
Thilina Gunawardena; Manujaya Godakandage; Sachith Abeywickrama; Rezni Cassim; Mandika Wijeyaratne
Abstract
Keywords
Resumo
Resumo: A cândida é uma causa rara de aneurismas da aorta infecciosos. Relatamos o caso de um paciente diabético com doença renal terminal, que foi submetido a reparo de aneurisma da aorta abdominal com vazamento. Ele estava em tratamento de longo prazo com antibióticos para otite externa maligna. A Candida albicans foi isolada da cultura da parede do aneurisma que sofreu a excisão. Não há relatos prévios de aneurisma da aorta infeccioso causado por cândida em pacientes com otite externa maligna. Este relato de caso visa reforçar que a cândida deve ser uma das suspeitas de causa de aneurisma da aorta infeccioso em pacientes debilitados e com imunossupressão crônica. O manejo desses casos pode ser extremamente desafiador, principalmente em contextos em que os recursos são escassos, e mencionaremos as vantagens e desvantagens das diversas opções de tratamento.
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References
1 Eggimann P, Que YA, Revelly JP, Pagani JL. Preventing invasive candida infections: where could we do better? J Hosp Infect. 2015;89(4):302-8.
2 Kumar SP, Ravikumar A, Somu L, Ismail NM. Malignant otitis externa: an emerging scourge. Journal of Clinical Gerontology and Geriatrics. 2013;4(4):128-31.
3 Cohen D, Friedman P. The diagnostic criteria of malignant external otitis. J Laryngol Otol. 1987;101(3):216-21.
4 Woodrum DT, Welke KF, Fillinger MF. Candida infection associated with a solitary mycotic common iliac artery aneurysm. J Vasc Surg. 2001;34(1):166-8.
5 Barry MC, Jackson N, Adeboysku D, Tran T, McNeil I, Grace PA. Candida albicans mycotic abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 1997;13(2):237-9.
6 Kretz B, Pagès PB, Loffroy R, et al. Mycotic aneurysm of both internal iliac arteries due to
7 Ikeda M, Kambayashi J, Kawasaki T. Contained rupture of infected abdominal aortic aneurysm due to systemic candidiasis. Cardiovasc Surg. 1995;3(6):711-4.
8 Marty-Ané C, Alric P, Prudhomme M, Picard E, Mary H. Bilateral splenorenal bypass and axillofemoral graft for management of juxtarenal mycotic aneurysm. Cardiovasc Surg. 1996;4(3):331-4.
9 Rubin BG, German ML. Candida infection with aneurysm formation in the juxtarenal aorta. J Vasc Surg. 1994;20(2):311-4.
10 Brown C Jr, Propp S, Guest CM, Beebe RT, Early L. Fatal fungus infections complicating antibiotic therapy. J Am Med Assoc. 1953;152(3):206-7.
11 Dubois M, Daenens K, Houthoofd S, Peetermans WE, Fourneau I. Treatment of mycotic aneurysms with involvement of the abdominal aorta: single-centre experience in 44 consecutive cases. Eur J Vasc Endovasc Surg. 2010;40(4):450-6.
12 Nemoto Y, Hosoi Y, Hoshina K, Nunokawa M, Kubota H, Watanabe T. In Situ Reconstruction with Extended Debridement in Patients with Mycotic Abdominal Aortic Aneurysms. Ann Vasc Dis. 2017;10(2):159-63.
13 Fichelle JM, Tabet G, Cormier P, et al. Infected infrarenal aortic aneurysms: when is in situ reconstruction safe? J Vasc Surg. 1993;17(4):635-45.
14 Janko MR, Bose S, Lawrence PF. Current status of treatment for aortic graft infection: when should cryopreserved allografts be used? Semin Vasc Surg. 2019;32(1-2):81-7.
15 Hayes PD, Nasim A, London NJ, et al. In situ replacement of infected aortic grafts with rifampicin-bonded prostheses: the Leicester experience (1992 to 1998). J Vasc Surg. 1999;30(1):92-8.
16 Kan CD, Lee HL, Yang YJ. Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review. J Vasc Surg. 2007;46(5):906-12.
17 Oichi T, Sasaki S, Tajiri Y. Spondylodiscitis concurrent with infectious aortic aneurysm caused by Candida tropicalis: a case report. J Orthop Surg (Hong Kong). 2015;23(2):251-4.
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