An unusual presentation of invasive Fusarium aortitis in a patient who is immunocompromised: A case report.

Autor:	Furaijat G; University of Ulm, Department of Internal Medicine I, Ulm, Germany., Bettac L; University of Ulm, Department of Internal Medicine I, Ulm, Germany., Kächele M; University of Ulm, Department of Internal Medicine I, Ulm, Germany., Grüner B; University of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Ulm, Germany., Skrabal C; University of Ulm, Department of Cardiac, Thoracic and Vascular Surgery, Ulm, Germany., Barth TFE; University of Ulm, Institute of Pathology, Ulm, Germany., Parlak M; University of Ulm, Department of Ophthalmology, Ulm, Germany., Hagemann JB; University of Ulm, Institute of Medical Microbiology and Hygiene, Ulm, Germany., Peters L; University of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Ulm, Germany., Walther G; German National Reference Center for Invasive Fungal Infections, Leibniz Institute for Natural Product Research, and Infection Biology - Hans Knöll Institute, Jena, Germany., Kersten J; University of Ulm, Division of Sports and Rehabilitation Medicine, Ulm, Germany. Electronic address: Johannes.kersten@uni-ulm.de.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2023 Sep; Vol. 134, pp. 102-105. Date of Electronic Publication: 2023 Jun 05.
DOI:	10.1016/j.ijid.2023.05.069
Abstrakt:	Fusarium (F.) species are ubiquitous filamentous fungi that may cause various opportunistic infections, especially in patients who are immunocompromised. A rare manifestation of disseminated fusariosis affects the aortic valve and results in invasive aortitis, which poses a significant challenge for clinicians in diagnosis and treatment. Here, we report a case of a patient, aged 54 years, who is immunocompromised, presenting initially with Fusarium keratitis and chorioretinitis in both eyes and a new endovascular aortic mass. Positron emission tomography/computed tomography was performed, suggesting aortitis. Transoesophageal echocardiography and electrocardiogram-guided computed tomography-angiography confirmed a large intraluminal mass in the ascending aorta. The aortic mass and a part of the ascending aorta were resected surgically, and a filamentous fungus with the microscopic features of the genus Fusarium was isolated and later identified molecularly as F. petroliphilum. The course of the treatment was complicated by perioperative cerebral embolization and mesenteric ischemia. These complications could be attributed to a preoperatively existing occlusion of the superior and inferior mesenteric artery and a subtotal stenosis of the celiac trunk. This case report describes a rare manifestation of disseminated fusariosis, frequently characterized by protracted clinical courses with poor prognosis. Fusariosis may manifest at different sites at different times or persist as a long-lasting disease with reactivation. This case highlights the importance of the interdisciplinary approach for effectively treating invasive mycoses. Competing Interests: Declaration of competing interest The authors have no competing interest to declare. (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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