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• W2079745382 abstract "The infection of an aortotomy scar is a very infrequent clinical entity, and even more so if it has a fungal origin. A 66-year-old male who visited the casualty department because of a high temperature, hypotension and acute ischemia in both lower limbs, 24 hours after presentation. Notable pathological antecedents included the replacement of an aortic valve with a mechanical valve 17 years earlier. Diagnostic arteriography showed a bilateral embolic occlusion of the distal popliteal artery and the patient was submitted to a bilateral popliteal thromboembolectomy, with remission of the acute ischemic syndrome. Anatomopathological analysis of the clots revealed hyphae that were compatible with Aspergillus sp. Treatment was begun with endovenous amphotericin B and valve replacement. During the course of the operation, the presence of vegetation was detected at the site of the earlier aortotomy. During the post-operative period following cardiac surgery the patient died from an acute myocardial infarction. We report an infrequent form of aortitis, which entails diagnostic and therapeutic difficulties, and which is usually accompanied by high mortality rates. La infección de una cicatriz de aortotomía es una entidad clínica muy poco frecuente, más aún si es de origen fúngico. Varón de 66 años que acudió a urgencias por fiebre, hipotensión e isquemia aguda de ambos miembros inferiores, de 24 horas de evolución. Entre sus antecedentes patológicos destacaba la sustitución valvular aórtica hacía 17 años por una válvula mecánica. La arteriografía diagnóstica mostró la oclusión embólica bilateral de la poplítea distal, y se le practicó una tromboembolectomía poplítea bilateral con remisión del síndrome isquémico agudo. El análisis anatomopatológico de los émbolos mostró hifas compatibles con Aspergillus sp. Se inició el tratamiento con anfotericina B endovenosa y sustitución de la válvula. En el acto operatorio, se detectó la presencia de una vegetación sobre la aortotomía previa. En el postoperatorio de la cirugía cardíaca el paciente falleció por un infarto agudo de miocardio. Se presenta una forma infrecuente de aortitis, que lleva implícitas dificultades diagnósticas y terapéuticas, y que habitualmente se acompaña de altas tasas de mortalidad. A infecção de uma cicatriz de aortotomia é uma entidade clínica muito pouco frequente, mais ainda se for de origem fúngica. Homem de 66 anos de idade que recorreu às urgências por febre, hipotensão e isquemia aguda de ambos os membros inferiores, com 24 horas de evolução. Entre os seus antecedentes patológicos destacavamse a substituição valvular aórtica há 17 anos por uma válvula mecânica. A arteriografia diagnóstica mostrou a oclusão embólica bilateral da popliteia distal, e realizouse uma tromboembolectomia popliteia bilateral com remissão da síndroma isquémica aguda. A análise anatomopatológica dos êmbolos mostrou hifas compatíveis com Aspergillus sp. Iniciou-se tratamento com anfotericina B endovenosa e substituição da válvula. No acto operatório, detectou-se apresença de uma vegetação sobre a aortotomia prévia. No pós-operatório da cirurgia cardíaca, o doente faleceu por um enfarte agudo do miocárdio. Apresenta-se uma forma rara de aortite, que leva implícitas dificuldades de diagnóstico e de terapêutica, e que habitualmente é acompanhada por elevadas taxas de mortalidade." @default.
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• W2079745382 date "2002-01-01" @default.
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• W2079745382 title "Embolismo poplíteo bilateral secundario a infección fúngica sobre cicatriz de aortotomía" @default.
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• W2079745382 doi "https://doi.org/10.1016/s0003-3170(02)74777-9" @default.
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