Miller B M, Waterhouse G, Alford R H, Dean R H, Hawkins S S, Smith B M
Ann Surg. 1983 Jan;197(1):57-62.
Fungal endarteritis resulting from progressive disseminated histoplasmosis may cause arterial aneurysms, or lead to infection of pre-existing aneurysms. Three patients with Histoplasma capsulatum infections of abdominal aortic aneurysms are reported. All had previous disseminated histoplasmosis and atherosclerotic peripheral vascular disease. All were considered cured of systemic infection when their aneurysms were discovered. Atherosclerotic vascular lesions may become infected during the course of systemic fungal disease and may serve as a haven for viable organisms in patients whose dissemination recurs despite seemingly adequate antifungal therapy. In treating these patients, resection of all infected arterial tissue, revascularization through uninfected tissues, and long-term antimicrobial therapy are recommended.
进行性播散性组织胞浆菌病引起的真菌性动脉内膜炎可导致动脉动脉瘤，或引发已存在动脉瘤的感染。本文报告了3例腹主动脉瘤感染荚膜组织胞浆菌的患者。所有患者既往均有播散性组织胞浆菌病和动脉粥样硬化性外周血管疾病。在发现动脉瘤时，所有患者均被认为全身感染已治愈。动脉粥样硬化性血管病变可能在全身性真菌病病程中被感染，对于那些尽管接受了看似充分的抗真菌治疗但仍复发播散的患者，这些病变可能成为存活病原体的庇护所。在治疗这些患者时，建议切除所有受感染的动脉组织，通过未受感染的组织进行血管重建，并进行长期抗菌治疗。
