Fungal Infection of Aortoiliac Endograft: A Case Report and Review of the Literature

Infection of aortoiliac endografts is, to date, a rare complication of endovascular surgery. Staphylococcus species are the most common responsible pathogens, just as in cases with infected grafts after open aortic surgery. We report a case of a 65-year-old man with a history of diabetes mellitus and bladder cancer who developed stent-graft infection 3 years after endovascular treatment for a 5.6 cm abdominal aortic aneurysm. The diagnosis of endograft infection was established radiologically by computed tomographic scans. After intravenous administration of antibiotics and fluids to improve his clinical condition, the patient underwent surgical excision of the infected prosthesis and a bifurcated rifampicin-impregnated Dacron graft was placed in situ. Cultures from the purulent fluid around the aorta and from the endograft revealed development of Candida albicans. To our knowledge, this is the first case of an infected endograft due to a fungus. The patient died from septic shock 3 days postoperatively in the intensive care unit.