Aortic Mycetoma with Exserohilum .
Joyce Zhuang, Omneya Kandil, Juan M Farina et al.
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Case in brief
A patient developed neurologic symptoms two months after root-sparing repair of an ascending aortic aneurysm and aortic valve replacement. Multimodal imaging showed irregular densities within the aortic lumen and graft, interpreted as an infectious thrombus. The patient underwent redo aortic aneurysm repair and valve replacement; culture of the extracted thrombus identified Exserohilum, a dematiaceous mold, confirming aortic mycetoma.
What made this case unusual
The report describes aortic mycetoma caused by Exserohilum, an unusual fungal cause of an infectious thrombus involving an aortic graft.
Diagnostic / clinical pearl
In a patient with neurologic symptoms after aortic surgery, irregular aortic or graft densities on multimodal imaging may represent infectious thrombus; culture of extracted material can establish the organism.