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Fungal aortitis with mycotic aneurysms

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Sepsis and abdominal pain.

Patient Data

Age: 70 years
Gender: Male

Stranding and wall thickening involving a 5 cm length of the distal abdominal aorta at the bifurcation. This extends to involve approximately 2 cm of the proximal aspects of both common iliac arteries. The finding is in keeping with aortitis.

There are lobulated saccular aneurysms arising from the aortitis. 

There is an associated peri-aortic collection with gas extending anterior and inferior to the aorta.

Case Discussion

CT-guided biopsy of the peri-aortic inflammatory mass was performed and Aspergillus fumigatus was isolated. 

Fungal infection is a rare cause of aortitis, with Candida and Aspergillus the most common fungi. 

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