Long-Term Azole Therapy After Subtotal Graft Removal for
- 1Department of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Kanagawa, Japan; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
- 2Department of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Kanagawa, Japan
Abstract
Background: Trichosporonosis is a fatal opportunistic infection (mortality 30%-90%). Trichosporon aortic prosthetic graft infection has not been reported. Case Summary: A 55-year-old immunocompetent man developed Trichosporon asahii aortic graft infection 3 months after type A dissection repair, presenting with fever and peripheral emboli. At redo total arch replacement, the infected woven polyester graft was excised, but the expanded polytetrafluoroethylene stent graft was too deep in the descending aorta to remove and was retained after debridement. Long-term azole therapy achieved control without recurrence over 2 years. Discussion: Diagnosis is difficult because culture-negative cases are not uncommon in prosthetic cardiovascular infection, and optimal management is undefined. The favorable outcome despite a retained expanded polytetrafluoroethylene segment may reflect its lower biofilm formation than woven polyester, though this remains speculative. Take-Home Messages: Consider T asahii in culture-negative graft infection. When explantation is unsafe, subtotal removal plus long-term azole therapy can be effective.
Related
- Chart-Recorded Hourly Patient Fluid-Removal Intensity and 90-Day Mortality After a 12-Hour Landmark During Continuous Renal Replacement Therapy
- Cannabidiol oil therapy for function-limiting keloids associated with graft-versus-host disease: A case report
- Modified C-shaped negative pressure wound therapy for skin graft fixation on digits: A case report
- Baricitinib as Salvage Therapy for Multidrug-Resistant Chronic Graft-Versus-Host Disease.
- Early postoperative galectin-3 for risk stratification of delayed graft function after kidney transplantation
BibTeX
@article{akihitoarai2026longterm,
title = {{Long-Term Azole Therapy After Subtotal Graft Removal for}},
author = {Akihito Arai, MD and Ryo Izubuchi, MD and Kenichiro Takahashi, MD, PhD and Manato Saito, MD and Minako Hayakawa, MD and Mimiko Tabata, MD, PhD},
journal = {JACC: Case Reports},
year = {2026},
month = nov,
doi = {10.1016/j.jaccas.2026.110548},
url = {https://doi.org/10.1016/j.jaccas.2026.110548},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-Term Azole Therapy After Subtotal Graft Removal for
AU - Akihito Arai, MD
AU - Ryo Izubuchi, MD
AU - Kenichiro Takahashi, MD, PhD
AU - Manato Saito, MD
AU - Minako Hayakawa, MD
AU - Mimiko Tabata, MD, PhD
PY - 2026
DA - 2026/11/06
JO - JACC: Case Reports
DO - 10.1016/j.jaccas.2026.110548
UR - https://doi.org/10.1016/j.jaccas.2026.110548
AB - Background: Trichosporonosis is a fatal opportunistic infection (mortality 30%-90%). Trichosporon aortic prosthetic graft infection has not been reported. Case Summary: A 55-year-old immunocompetent man developed Trichosporon asahii aortic graft infection 3 months after type A dissection repair, presenting with fever and peripheral emboli. At redo total arch replacement, the infected woven polyester graft was excised, but the expanded polytetrafluoroethylene stent graft was too deep in the descending aorta to remove and was retained after debridement. Long-term azole therapy achieved control without recurrence over 2 years. Discussion: Diagnosis is difficult because culture-negative cases are not uncommon in prosthetic cardiovascular infection, and optimal management is undefined. The favorable outcome despite a retained expanded polytetrafluoroethylene segment may reflect its lower biofilm formation than woven polyester, though this remains speculative. Take-Home Messages: Consider T asahii in culture-negative graft infection. When explantation is unsafe, subtotal removal plus long-term azole therapy can be effective.
SN - 2666-0849
ER -