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Graft Infection of Thoracic Aorta Due to Group Cb-Hemolytic Streptococcus

A Case Report

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Masaharu Nagata, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Kiichiro Fujisaki, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Masaki Gushima, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Kiyoshi Matsumura, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan, matsumk{at}intmed2.med.kyushu-u.ac.jp

Koji Fujii, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Takuya Tsuchihashi, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Hideki Hirakata, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Takashi Eguchi, MD

Department of Anatomic Pathology, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Yoichi Moroi, MD

Department of Dermatology, Graduate School of Medical Sciences, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Masutaka Furue, MD

Department of Dermatology, Graduate School of Medical Sciences, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Hisataka Yasui, MD

Division of Cardiovascular Surgery, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Masazumi Tsuneyoshi, MD

Department of Anatomic Pathology, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

Mitsuo Iida, MD

Department of Medicine and Clinical Science, Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan

A fatal case of late-onset graft infection of the thoracic aorta due to group C b-hemolytic streptococcus is described. A 37-year-old male patient, who had a history of total aortic arch replacement for acute aortic dissection 8 years before, was admitted to the department. He suffered from toxic shock syndrome, disseminated intravascular coagulation (DIC), and acute renal failure. Group C b-hemolytic streptococcus was detected from his blood; however, echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) failed to detect the focus of the infection. In spite of intensive care, including antibiotic therapy, artificial ventilation, and continuous hemodiafiltration, he died on the 18th day of hospitalization. Autopsy revealed that a small abscess was present at the proximal anastomotic segments of the patient’s graft. A bite inflicted by his dog, 14 days before admission, was suspected to be the source of this bacterium. A rare case of graft infection of thoracic aorta in terms of causative organism, long period from graft replacement to graft infection, and site of infection is presented and discussed.

Angiology, Vol. 56, No. 2, 237-241 (2005)
DOI: 10.1177/000331970505600217


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