Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.210122
Jornal Vascular Brasileiro
Case Report

Mycotic aortic aneurysm in a debilitated patient with compromised immunity; beware of Candida!

Aneurisma micótico da aorta em paciente debilitado com imunidade comprometida – um alerta para Cândida

Thilina Gunawardena; Manujaya Godakandage; Sachith Abeywickrama; Rezni Cassim; Mandika Wijeyaratne

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Abstract

Abstract: Candida is a rare cause of infected aortic aneurysms. We report the case of a diabetic patient with end stage kidney disease who underwent repair of a leaking abdominal aortic aneurysm. He was on long-term antibiotic treatment for malignant otitis externa. Candida albicans was isolated from the culture of the excised aneurysm wall. An infected aortic aneurysm due to Candida has not been previously reported in a patient with malignant otitis externa. This case report aims to highlight that Candida should be suspected as a cause of infected aortic aneurysms in patients with debilitation and chronic immunosuppression. Management of such cases can be extremely challenging, especially in resource-poor settings, and we will be touching upon the advantages and disadvantages of various treatment options.

Keywords

malignant otitis externa, candida, mycotic aneurysm, in situ repair

Resumo

Resumo: A cândida é uma causa rara de aneurismas da aorta infecciosos. Relatamos o caso de um paciente diabético com doença renal terminal, que foi submetido a reparo de aneurisma da aorta abdominal com vazamento. Ele estava em tratamento de longo prazo com antibióticos para otite externa maligna. A Candida albicans foi isolada da cultura da parede do aneurisma que sofreu a excisão. Não há relatos prévios de aneurisma da aorta infeccioso causado por cândida em pacientes com otite externa maligna. Este relato de caso visa reforçar que a cândida deve ser uma das suspeitas de causa de aneurisma da aorta infeccioso em pacientes debilitados e com imunossupressão crônica. O manejo desses casos pode ser extremamente desafiador, principalmente em contextos em que os recursos são escassos, e mencionaremos as vantagens e desvantagens das diversas opções de tratamento.
 

Palavras-chave

otite externa maligna, cândida, aneurisma micótico, reparo in situ

References

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