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Case Reports
. 2021 Dec 22:14:843-847.
doi: 10.2147/IMCRJ.S340364. eCollection 2021.

Incidental Finding of an Aspergillus Pseudoaneurysm in the Ascending Aorta of an Immunocompetent Patient

Rola Ali  1   2   3 , Abdullah Elhosiny  1   2 , Seraj Abualnaja  2   4 , Ghassan Baslaim  2   4
Affiliations
Case Reports

Incidental Finding of an Aspergillus Pseudoaneurysm in the Ascending Aorta of an Immunocompetent Patient

Rola Ali et al. Int Med Case Rep J. .

Abstract

Pseudoaneurysms of the ascending aorta are rare, yet they are life-threatening conditions and usually associated with poor outcomes due to insidious presentation. Many different etiologies have been associated with aortic pseudoaneurysms including; atherosclerosis, infections, connective tissue disorders, and traumatic causes. In addition, aortic pseudoaneurysms have been reported following thoracic surgeries, including aortic valve replacements, aortic dissection repair, and coronary artery bypass grafting. Aspergillus is amongst the infectious etiologies of pseudoaneurysms. Aspergillus species is a ubiquitous mold (fungus) that is mostly harmless but may result in serious illnesses in immunocompromised hosts with hematologic neoplasms, neutropenia, or immunodeficiency syndromes. In this paper, we report a case of an ascending aortic pseudoaneurysm caused by Aspergillus infection. To our knowledge, this is an exceptionally rare case diagnosed incidentally in an immunocompetent patient, who is surgically free and without any pre-existing risk factors.

Keywords: aorta; aspergillosis; pseudoaneurysm.

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Conflict of interest statement

Dr Seraj Abualnaja's current affiliation is Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia. The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
CT angiogram of the aorta with contrast revealing the pseudoaneurysm measuring 2.4×1.5 cm (as pointed by the arrow).
Figure 2
Figure 2
3-D CT angiogram of the aorta and its major branches, with arrow pointing towards the pseudoaneurysm.
Figure 3
Figure 3
Intraoperative view – revealing dense pericardial adhesions, purulent material (indicated by the arrow) over the aortic root and anterior wall of the right ventricle, and ascending aortic pseudoaneurysm.
Figure 4
Figure 4
Histopathology view of the biopsy revealing necrotic granulomatous lesion (arrow pointing towards the necrotic granuloma) – with multinucleated giant cells surrounding central necrosis.
See this image and copyright information in PMC

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