Acute aortic occlusion from a Candida fungus ball

Abstract

Fungal arterial infections are well-described entities resulting in direct invasion of the arterial wall or embolic occlusion of small and medium-sized arteries. However, acute occlusion of large vessels such as the aorta by fungal material is exceedingly rare. A 53-year-old woman presented with acute bilateral lower extremity ischemia. She had a history of fungal endocarditis requiring two prosthetic mitral valve replacements; the last episode was 7 months before the current admission. Imaging studies revealed that she had an acute infrarenal aortic occlusion, with evidence of multiple end-organ emboli. After transfemoral thromboembolectomy, perfusion was restored to her lower extremities with minor neurologic sequelae. She ultimately responded to intravenous antifungal agents.

Fungal prosthetic aortic valve endocarditis and endarteritis: An unusual cause of aortic root vegetations

“…[27][28][29] Multiple cases of CEID lead infections have been reported in the literature. 42 The patient in that case report had acute infrarenal aortic occlusion The appearance is consistent with mycotic aneurysms. 38,39 Extracardiac sites of infection following Candida endocarditis have also been described.…”

“…To date, there is only one case in the medical literature of a C albicans vegetation found in the aorta. 42 The patient in that case report had acute infrarenal aortic occlusion Candidal aortic aneurysms are rare. There are two case reports of aortic aneurysms caused by candidiasis: One was an aortic root aneurysm following heart transplant as mentioned above and the other was a juxtarenal aortic aneurysm.…”

"I Can't Walk!" Acute Thrombosis of Descending Aorta Causing Paraplegia

“…Acute aortic occlusion is an infrequent surgical emergency, but should be considered as part of the differential diagnosis in the ED in patients presenting with bilateral loss of motor function, sensation and pulses 2–4,6,10. The differential in this case also includes spinal cord compression from prostate cancer or a spinal abscess (history of intravenous drug abuse) 1,4.…”

Paraplegia Due to Aortic Occlusion from a Fungal Ball

“…1 Valvular vegetations are regularly encountered in fungal endocarditis and frequently embolize to end organs via small and medium-sized arteries; however, an embolus that is large enough to occlude the aorta is rare. 2 In this report we describe a case of multiple emboli caused by aortic valve candidiasis in an immunocompromised patient with acute paraplegia due to an aortic occlusion.…”