Images in Clinical Medicine

Septic (Aspergillus) Embolus

Dwayne Ledesma, M.D., and William H. Pearce, M.D.

N Engl J Med 2000; 342:1015April 6, 2000

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Figure 1 A 61-year-old man with a prosthetic aortic valve presented with acute ischemia of the right foot. An embolectomy of the dorsalis pedis and posterior tibialis arteries was performed. Culture of the thrombus revealed Aspergillus fumigatus. On microscopical examination (hematoxylin and eosin, ×400), aspergillus hyphae appeared as broad, septate filaments of uniform width (5 to 10 μm), with a characteristic branching angle of 45 degrees (arrows). A transesophageal echocardiogram disclosed multiple aortic-valve vegetations. The patient's prosthetic aortic valve was replaced, and he was treated with amphotericin B, but he died of a ruptured mycotic aneurysm of the ascending aorta 10 days after surgery.

Dwayne Ledesma, M.D.
William H. Pearce, M.D.
Northwestern University Medical School, Chicago, IL 60611

Citing Articles (3)

Citing Articles

1. 1

   Elizabeth Cerceo, Robert M. Kotloff, Denis Hadjiliadis, Vivek N. Ahya, Alberto Pochettino, Colin Gillespie, Jason D. Christie. (2009) Central Airways Obstruction Due to Aspergillus fumigatus After Lung Transplantation. The Journal of Heart and Lung Transplantation 28:5, 515-519
   CrossRef

2. 2

   A. C. Pasqualotto, D. W. Denning. (2006) Post-operative aspergillosis. Clinical Microbiology and Infection 12:11, 1060-1076
   CrossRef

3. 3

   Angel Sanchez-Recalde, Isabel Maté, José L Merino, Raquel S Simon, José A Sobrino. (2003) Aspergillus aortitis after cardiac surgery. Journal of the American College of Cardiology 41:1, 152-156
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