• Lukas J Motloch, Dennis Rottlaender, Turak Darabi, Insa Joost, Erland Erdmann, and Uta C Hoppe.
• Department of Internal Medicine III, University of Cologne, 50937 Cologne, Germany. lukas.motloch@uk-koeln.de
• Tex Heart Inst J. 2011 Jan 1; 38 (2): 197-200.

AbstractCandida albicans infections after prosthetic graft implantation due to acute aortic dissection are rare. A combination of surgical resection and lifelong antifungal drug therapy is the gold standard for treatment of aortic graft infection, yet surgical interventions are associated with high mortality rates. Herein, we present the case of a 57-year-old man who presented with peripheral microembolism due to late-onset C. albicans infection of a prosthetic graft of the thoracic aorta, which was diagnosed by positron emission tomographic imaging. Given the high risk of reoperation, the patient was treated with intravenous caspofungin for 4 weeks, followed by oral administration of fluconazole. During a follow-up of 500 days, he remained asymptomatic, with slightly elevated inflammatory markers. This case suggests that in some instances, particularly in patients with high operative risk, Candida prosthetic graft infection can be managed conservatively with antifungal therapy alone. However, such an approach should be applied with caution and necessitates close follow-up on a long-term basis.

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