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April 5, 1976

Disseminated Histoplasmosis Involving an Aortofemoral Prosthetic Graft

Author Affiliations

From the Division of Pulmonary Medicine, Department of Medicine, Veterans Administration Hospital and the University of Colorado Medical Center, Denver. Dr Matthay is a fellow of the American Lung Association.

JAMA. 1976;235(14):1478-1479. doi:10.1001/jama.1976.03260400044031

ACUTE pulmonary histoplasmosis is usually a self-limited disease; however, the disseminated form is progressive and frequently fatal if untreated.1 Disseminated histoplasmosis has been reported to cause both endocarditis2 and mycotic aneurysm of the thoracic aorta.3 A patient is described in whom a previously implanted Dacron aortofemoral graft became infected with Histoplasma capsulatum. Our case illustrates that vascular prostheses are susceptible to fungal infections that are difficult to eradicate.

Report of a Case  A 46-year-old man had dyspnea, hemoptysis, and fever in February 1972. Three years earlier, a bifurcation graft from the aorta to the right common femoral and left external iliac arteries had been inserted for relief of intermittent claudication due to severe peripheral vascular disease. On admission, vital signs were normal except for a temperature of 38.5 C. Abnormalities on physical examination included bilateral basilar rales and a spleen palpable 3 cm below the left costal