Mycotic Common Iliac Artery Aneurysm Infected by Candida Albicans
Jin Hong Wi¹, Hyoung Chae Lee², Kyung-Taek Park¹, Il-Yong Han¹, Young Chul Yoon¹, Yang-Haeng Lee¹
¹Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea, ²Department of Thoracic and Cardiovascular Surgery, Dongkang Medical Center, Ulsan, Korea
Background : We report on a case of a common iliac artery aneurysm infected by Candida albicans. To our knowledge, only three cases of this condition has been reported.
Methods : The patient, a 84-year-old woman with hypertension, diabetes mellitus, old cerebral infarction and bedridden state due to chronic lumbar spondylitis, had an abdominal pain with a palpable, pulsating mass. A 5cm sized, saccular type aneurysm of the right common iliac artery without involvement of the aorta and iliac bifurcation was revealed by means of a computed tomography scan. The aneurysm abutted onto an infected lumbar vertebra. After femoro-femoral bypass to restore the arterial blood flow to right lower limb, the aneurysm was resected, and the proximal and distal margins were oversewn. Candida albicans was found as causative pathogen from resected specimens. The aneurysm may have formed by direct extension of infection of a lumbar vertebra.
Results : Intravenous fluconazole started to be given after confirming causative pathogen, and continued to maintain for about 4 weeks. She was discharged on postoperative day 22. At the eighteen-month follow-up, no evidence of recurrent infection has been shown.
Conclusion : A common iliac artery aneurysm infected by Candida albicans is an extremely rare condition. Removal of an aneurysm with restoring blood flow and proper antifungal therapy for an extended period most likely offers the best hope for palliation and prolonged survival.

책임저자: Jin Hong Wi
Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
발표자: Jin Hong Wi, E-mail : wiccy@hanmail.net