RESUMEN
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.
Asunto(s)
Prótesis Vascular/microbiología , Candida albicans , Candidiasis/diagnóstico , Infecciones Fúngicas del Sistema Nervioso Central/diagnóstico , Infecciones Relacionadas con Prótesis/diagnóstico , Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/efectos adversos , Candida albicans/aislamiento & purificación , Candidiasis/complicaciones , Candidiasis/terapia , Infecciones Fúngicas del Sistema Nervioso Central/complicaciones , Infecciones Fúngicas del Sistema Nervioso Central/terapia , Diagnóstico Precoz , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/complicaciones , Infecciones Relacionadas con Prótesis/terapia , Resultado del TratamientoRESUMEN
We report a case of atypical hemolytic uremic syndrome (aHUS) triggered by influenza A (H1N1) in a 17-year-old boy with a mutation in the gene (CD46) encoding the transmembrane complement regulator membrane cofactor protein. The patient recovered completely following treatment with oseltamivir, plasma exchange, and hemodialysis. We describe the case and discuss this unusual association of diseases.