A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia

Background. An aortoenteric fistula (AEF) describes a communication of the aorta or aortic graft with an adjacent loop of the bowel. Aortic graft erosion is a rare complication of abdominal aortic aneurysm repair. We describe a case of a patient presenting with sepsis from Candida glabrata fungemia...

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Autores principales:	Muhammad Adeel Samad, Dhaval Patel, Martin Asplund, Diane C. Shih-Della Penna, Yaseen Tomhe
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/c7ccb79de0e04822a5cc5d60359d8e49
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spelling	oai:doaj.org-article:c7ccb79de0e04822a5cc5d60359d8e492021-11-29T00:55:49ZA Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia2090-699410.1155/2021/9002143https://doaj.org/article/c7ccb79de0e04822a5cc5d60359d8e492021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9002143https://doaj.org/toc/2090-6994Background. An aortoenteric fistula (AEF) describes a communication of the aorta or aortic graft with an adjacent loop of the bowel. Aortic graft erosion is a rare complication of abdominal aortic aneurysm repair. We describe a case of a patient presenting with sepsis from Candida glabrata fungemia secondary to aortoenteric erosion without any symptoms or signs of gastrointestinal bleeding. This is a unique case of Candida glabrata fungemia from aortoenteric graft erosion. Case Summary. This patient is a 75-year-old male with a history of a prior aortobifemoral bypass graft in 2005. He presented with complaints of right paraspinal pain and chills. He had no symptoms of gastrointestinal bleeding or abdominal pain. His white blood cell count was 25,600/mcl (4,000–11,000/mcL) with left shift. The erythrocyte sedimentation rate was 11 mm/hr (0-38 mm/hr), and C-reactive protein was 95.5 mg/L (<=10.0 mg/L). Blood cultures were obtained and eventually grew Candida glabrata. A computed tomography angiogram (CTA) of abdomen and pelvis demonstrated inflammation surrounding the graft concerning for graft infection with additional inflammatory changes tracking down both femoral limbs. He underwent staged bilateral femoralaxillary bypass followed by the excision of aortobifemoral bypass. Conclusion. Patients with aortoenteric erosion can present with sepsis in absence of gastrointestinal bleeding. Emergent computed tomography angiogram (CTA) of abdomen and pelvis should be performed to assess for aortic graft erosion or fistula. Empiric treatment with antibiotics should include antifungal agent like micafungin until the final culture is reported. The definite management is an extra anatomic bypass, followed by graft excision.Muhammad Adeel SamadDhaval PatelMartin AsplundDiane C. Shih-Della PennaYaseen TomheHindawi LimitedarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENCase Reports in Vascular Medicine, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Muhammad Adeel Samad Dhaval Patel Martin Asplund Diane C. Shih-Della Penna Yaseen Tomhe A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
description	Background. An aortoenteric fistula (AEF) describes a communication of the aorta or aortic graft with an adjacent loop of the bowel. Aortic graft erosion is a rare complication of abdominal aortic aneurysm repair. We describe a case of a patient presenting with sepsis from Candida glabrata fungemia secondary to aortoenteric erosion without any symptoms or signs of gastrointestinal bleeding. This is a unique case of Candida glabrata fungemia from aortoenteric graft erosion. Case Summary. This patient is a 75-year-old male with a history of a prior aortobifemoral bypass graft in 2005. He presented with complaints of right paraspinal pain and chills. He had no symptoms of gastrointestinal bleeding or abdominal pain. His white blood cell count was 25,600/mcl (4,000–11,000/mcL) with left shift. The erythrocyte sedimentation rate was 11 mm/hr (0-38 mm/hr), and C-reactive protein was 95.5 mg/L (<=10.0 mg/L). Blood cultures were obtained and eventually grew Candida glabrata. A computed tomography angiogram (CTA) of abdomen and pelvis demonstrated inflammation surrounding the graft concerning for graft infection with additional inflammatory changes tracking down both femoral limbs. He underwent staged bilateral femoralaxillary bypass followed by the excision of aortobifemoral bypass. Conclusion. Patients with aortoenteric erosion can present with sepsis in absence of gastrointestinal bleeding. Emergent computed tomography angiogram (CTA) of abdomen and pelvis should be performed to assess for aortic graft erosion or fistula. Empiric treatment with antibiotics should include antifungal agent like micafungin until the final culture is reported. The definite management is an extra anatomic bypass, followed by graft excision.
format	article
author	Muhammad Adeel Samad Dhaval Patel Martin Asplund Diane C. Shih-Della Penna Yaseen Tomhe
author_facet	Muhammad Adeel Samad Dhaval Patel Martin Asplund Diane C. Shih-Della Penna Yaseen Tomhe
author_sort	Muhammad Adeel Samad
title	A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
title_short	A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
title_full	A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
title_fullStr	A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
title_full_unstemmed	A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia
title_sort	rare case of aortoenteric graft erosion presenting as candida glabrata fungemia
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/c7ccb79de0e04822a5cc5d60359d8e49
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A Rare Case of Aortoenteric Graft Erosion Presenting as Candida glabrata Fungemia

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