Aortic Pseudoaneurysm Due to Aspergillus Fumigatus in a Patient With Post Coronary Artery Bypass Graft Surgery Publisher



Pargar A ; Meidani M ; Alijani N ; Ghiasvand F ; Yazdi NA ; Javanbakht M ; Roozpeykar S
Source: Clinical Infection in Practice Published:2026

Abstract

BackgroundAortic pseudoaneurysm, also called false aneurysm, is uncommon but potentially fatal complication, typically arising at sites of arterial wall damage (Garisto et al, 2010; Stolt et al, 2018). Aortic pseudoaneurysm commonly develops after cardiac surgery, particularly at sites of anastomosis or cannulation, where impaired healing can defect the arterial wall (Razzouk et al., 1993; Mesana et al., 2000).Case presentationA 60-year-old male, four months post-coronary artery bypass grafting (CABG), presented with a three-week history of fever of unknown origin. His medical history included splenectomy for idiopathic thrombocytopenic purpura (ITP).He was not taking any immunosupprepressive drugs. Lab tests showed elevated C-reactive protein but normal cultures and autoimmune markers. Imaging revealed a saccular pseudoaneurysm in the ascending aorta, confirmed by CT angiography. Surgical repair was performed, and tissue biopsy was morphologically consistent with Aspergillus species. PCR confirmed Aspergillus fumigatus. The patient was treated with voriconazole for one year, achieving complete clinical resolution.ConclusionThis case highlights a rare Aspergillus-related aortic pseudoaneurysm in a post-CABG patient with asplenia, emphasizing the importance of timely diagnosis and early surgical treatment and prolonged antifungal therapy. © 2026 Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/