Early fungal infection in an aortic prosthesis with probable cerebral metastasis: the success of a conservative strategy.

Infection of an aortic prosthesis presents a diagnostic and therapeutic challenge. Fungal infections are rarely described and among these Candida spp. are the most prevalent agents. Although the therapeutic approach to prosthetic bacterial infection may be conservative, in the case of fungal etiology, surgery, such as the removal and substitution of the device, debridement and repair of the infected prosthesis is usually warranted. The authors describe the case of a 48-year-old man, with a thoraco-abdominal aneurysm of the aorta, submitted to surgery for insertion of a prosthetic aortic duct. The procedure was made difficult by Candida albicans empyema associated with an aortic prosthesis infection that was complicated by probable cerebral metastasis. Antifungal therapy was the initial option, as the steady clinical, laboratory and radiological improvement deferred a surgical intervention. This case demonstrates the success of a conservative approach in a very serious fungal infection of a thoraco-abdominal aorta prosthesis.