Metwalli Eslam, Warwick Richard, Al Shakarchi Julien
Vascular Surgery Department, Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester WR5 1DD, Worcestershire, United Kingdom.
Cardiothoracic Surgery Department, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent ST4 6QG, Staffordshire, United Kingdom.
J Surg Case Rep. 2025 Jun 16;2025(6):rjaf418. doi: 10.1093/jscr/rjaf418. eCollection 2025 Jun.
Aspergillus niger aortitis is a rare but life-threatening fungal infection, typically affecting immunocompromised individuals. We present a unique case of a patient presenting with bilateral acute lower limb ischemia and a recent history of aortic valve repair. Despite the absence of typical infectious symptoms, further investigation revealed an infected floating thrombus in the ascending aorta. Subsequent surgical intervention and pathological analysis confirmed the presence of Aspergillus niger, a common environmental Mold, as the causative agent of aortitis. Our case highlights the challenges of diagnosing and managing Aspergillus niger aortitis, as symptoms can be subtle, and routine laboratory tests may not always detect the infection. Previous cardiac surgery is recognized as a significant risk factor for developing Aspergillus niger aortitis. This case report underscores the importance of considering Aspergillus niger aortitis in the differential diagnosis of patients with a history of cardiac surgery who present with unexplained embolic events, such as acute limb ischemia. Immediate recognition, decisive surgical intervention, and the initiation of appropriate antifungal therapy are imperative for maximizing patient outcomes in this complex condition.
黑曲霉性主动脉炎是一种罕见但危及生命的真菌感染，通常影响免疫功能低下的个体。我们报告了一例独特的病例，患者表现为双侧急性下肢缺血，近期有主动脉瓣修复史。尽管没有典型的感染症状，但进一步检查发现升主动脉有感染性漂浮血栓。随后的手术干预和病理分析证实，常见环境霉菌黑曲霉是主动脉炎的病原体。我们的病例突出了诊断和管理黑曲霉性主动脉炎的挑战，因为症状可能很细微，常规实验室检查可能并不总能检测到感染。既往心脏手术被认为是发生黑曲霉性主动脉炎的重要危险因素。本病例报告强调，对于有心脏手术史且出现不明原因栓塞事件（如急性肢体缺血）的患者，在鉴别诊断中考虑黑曲霉性主动脉炎的重要性。对于这种复杂情况，立即识别、果断的手术干预以及开始适当的抗真菌治疗对于最大化患者预后至关重要。
