Case Report: Coccidioides Immitis Infects a Patient’s Vascular Graft

Vascular graft infections are rare & usually caused by Staphylococcus, Streptococcus or Pseudomonas shortly after the procedure. Aortic graft infection caused by fungus is extremely rare.

Discussion

Aortitis from an infected vascular graft must be considered in patients who have had surgical repair of the aorta. Vascular graft infections are rare and usually caused by Staphylococcus, Streptococcus or Pseudomonas shortly after the procedure.¹ Aortic graft infection caused by fungus is extremely rare.^2-4

To decrease morbidity and mortality associated with infected vascular graft, it is extremely important to establish the correct diagnosis and initiate appropriate treatment in a timely manner. Physicians must consider the possibility of aortitis due to a vascular graft infection caused by Coccidioides immitis in patients who are residents of or have recently traveled to endemic regions, including Arizona, California, Texas, New Mexico, Utah and Nevada.

Manjinder Kaur, DO, is a rheumatology fellow in the Department of Medicine at the University of Arizona, Tucson.

Sabina Mian, MD, is a clinical assistant professor in the Division of Rheumatology at the University of Arizona, Tucson.

References

1. Young MH, Upchurch GR Jr., Malani PN. Vascular graft infections. Infect Dis Clin North Am. 2012 Mar;26(1):41–56.
2. Doscher W, Krishnasastry KV, Deckoff SL. Fungal graft infections: Case report and review of the literature. J Vasc Surg. 1987 Oct;6(4):398–402.
3. Nemoto T, Tokuda Y, Hirose M, et al. Thoracic aortic graft infection due to Candida albicans with multiple embolism in the left-side vessels of the body. Intern Med. 2017;56(9):1107–1111.
4. Zosimas D, Abukar A, Srilekha A. A rare case of peripheral vascular graft infection by Aspergillus fumigatus and review of the literature. Ann R Coll Surg Engl. 2017 Jan;99(1):e34–e35.