Histoplasma Infection of Abdominal Aortic Aneurysms

Miller, Bonnie M.; Waterhouse, G; Alford, Robert H.; Dean, Richard H.; Hawkins, Stephens S.; Smith, Blaine E.

doi:10.1097/00000658-198301001-00009

Cited by 24 publications

(13 citation statements)

References 26 publications

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“…It is an infrequent cause of native and prosthetic valve endocarditis, 6-12 endarteritis, infected aortic aneurysms, and endovascular graft infections. [13][14][15] Endovascular histoplasmosis has also been diagnosed by pathologic assessment and analysis of an embolic event. 16,17 Here, we report the clinical presentation as well as diagnostic and histopathologic findings of 5 cases of confirmed H capsulatum endovascular infections at the Cleveland Clinic (Cleveland, Ohio).…”

mentioning

confidence: 99%

Endovascular Infections Caused by Histoplasma capsulatum: A Case Series and Review of the Literature

Ledtke¹,

Rehm²,

Fraser³

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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Histoplasma capsulatum endovascular infections are clinically characterized by a subacute febrile illness with negative bacterial cultures in patients with prosthetic endografts or valves. Noninvasive diagnostics are often the initial clue to the diagnosis. Combined medical and surgical treatment is associated with survival. On histopathologic examination both mycelial and yeast forms are often observed, with absent to minimal tissue inflammatory reaction.

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confidence: 99%

Endovascular Infections Caused by Histoplasma capsulatum: A Case Series and Review of the Literature

Ledtke¹,

Rehm²,

Fraser³

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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“…In immunocompetent patients, histoplasmosis is mostly a subclinical or self-limited disease that does not require treatment, however, in immunocompromised patients it can lead to disseminated or chronic pulmonary disease [ 22 ]. Fungal endarteritis is a rare disease process that can be a manifestation of disseminated histoplasmosis [ 23 ]. It has been found in cases to involve the thoracic and abdominal aorta as well as major peripheral arteries [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fungal endarteritis is a rare disease process that can be a manifestation of disseminated histoplasmosis [ 23 ]. It has been found in cases to involve the thoracic and abdominal aorta as well as major peripheral arteries [ 23 ]. These infections are typically associated with chronic immunosuppression, diabetes, and the use of contaminated needles by drug abusers [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of a mycotic splenic artery pseudoaneurysm secondary to histoplasmosis: a case report

Mirande,

Souza,

Thibodeaux

et al. 2024

surg case rep

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Background A splenic artery pseudoaneurysm is a rare pathology that occurs mainly secondary to pancreatitis, abdominal trauma, peptic ulcers, pancreatic and gastric cancers, and infections. It is best diagnosed using computed tomography angiography and typically treated using endovascular embolization and, in some cases, open or laparoscopic surgery. In this report, we present a case of a ruptured mycotic splenic artery pseudoaneurysm containing Histoplasma capsulatum, which to our knowledge is the first case to report a mycotic splenic artery pseudoaneurysm of this nature. Case presentation We report a case of a 42-year-old white male with past medical history of Hepatitis C and IV drug abuse who presented to the Emergency Department with a 24-h history of severe diffuse abdominal pain. He was tachycardic and peritonitic on exam. Work-up demonstrated leukocytosis and lactic acidosis. Computed tomography of the abdomen and pelvis with intravenous contrast showed hemoperitoneum and active extravasation of contrast from the splenic artery into the splenic hilum, associated with a surrounding hematoma measuring 5.3 × 5.0 cm, concerning for ruptured splenic artery pseudoaneurysm. The patient was taken emergently for exploratory laparotomy, where a large intraperitoneal hematoma was evacuated. A ruptured splenic artery pseudoaneurysm was identified, isolated, and controlled, followed by completion splenectomy. Final pathology demonstrated a 3.0 × 1.3 × 0.3 cm pseudoaneurysm wall and a 14 × 9.5 × 5.5 cm spleen containing multiple necrotizing granulomata positive for the presence of Histoplasmosis species. The patient recovered appropriately and was discharged on post-operative day five. Conclusions This case demonstrates a successful approach to a ruptured mycotic splenic artery pseudoaneurysm resulting in a positive outcome. It is a unique case as it highlights, to our knowledge, the first report of splenic artery aneurysm secondary to Histoplasma capsulatum infection. This report helps further the understanding of the pathophysiology as well as the natural history of mycotic splenic pseudoaneurysms.

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“…Nur in ca. In wenigen Fällen wurden Histoplasma capsulatum, Aspergillus fumigatis und Candida-Species nachgewiesen [9,10,13]. In wenigen Fällen wurden Histoplasma capsulatum, Aspergillus fumigatis und Candida-Species nachgewiesen [9,10,13].…”

Section: Diskussionunclassified

“…Beim ausgedehnten, inflammatorischen Prozeû wird der extra-anatomische Bypass bevorzugt [12]. Diese weist zudem eine bessere Durchgängigkeit auf als der längere, zu Thrombose nei-gende extra-anatomische Bypass [9]. Dadurch wird das Risiko eines Protheseninfekts verringert [7].…”

Section: Diskussionunclassified

Die Vena femoralis superficialis als Gefäßersatz bei der chirurgischen Therapie eines mykotischen Aneurysmas der Arteria iliaca communis

Schütz

Marti

Gürke

et al. 1998

Chirurg

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A 38-year-old polytoxicomanic male patient developed an occlusion of both popliteal arteries associated with an aneurysm of the right common iliac artery. A septic cause was suspected and an antimycotic therapy was instituted, but the diameter of the aneurysm increased to 3 cm during 6 months. Moreover, multiple periarterial abscesses occurred. The aneurysm was resected and the iliacal axis reconstructed in situ, using a superficial femoral vein interposition. Six months after operation, patency was confirmed by duplex sonography. Phlebodynamic examinations showed normal flow functions at the donor site.

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Histoplasma Infection of Abdominal Aortic Aneurysms

Cited by 24 publications

References 26 publications

Endovascular Infections Caused by Histoplasma capsulatum: A Case Series and Review of the Literature

Endovascular Infections Caused by Histoplasma capsulatum: A Case Series and Review of the Literature

Spontaneous rupture of a mycotic splenic artery pseudoaneurysm secondary to histoplasmosis: a case report

Die Vena femoralis superficialis als Gefäßersatz bei der chirurgischen Therapie eines mykotischen Aneurysmas der Arteria iliaca communis

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