Mycotic aneurysm of the thoracic aorta due to Aspergillus terreus: Case report and review

Mycotic aneurysms of the aorta caused by fungi are uncommon. We describe an unusual case of aortic aneurysm infection caused by Aspergillus terreus, w hich most likely spread from an adjacent pulmonary focus. Successful treatm ent included partial pneumonectomy, resection of the aneurysm with graft re pair, and prolonged sequential administration of amphotericin B and itracon azole. A review of the published experience with aortic aneurysms caused by Aspergillus species is also presented. When invasive aspergillosis is susp ected in proximity to areas with major vascular structures in immunocomprom ised patients, further investigation to rule out vascular invasion may be w arranted. If the diagnosis is confirmed, aggressive and prompt treatment wi th antifungal agents combined with surgical debridement is essential to imp rove outcome.