Long-Term Azole Therapy After Subtotal Graft Removal for Trichosporon asahii Aortic Graft Infection.

Authors

Akihito Arai, Ryo Izubuchi, Kenichiro Takahashi, Manato Saito, Minako Hayakawa, Mimiko Tabata

Published in

JACC. Case reports. Pages 110548. Sep 29, 2026. Epub Sep 29, 2026.

Abstract

Trichosporonosis is a fatal opportunistic infection (mortality 30%-90%). Trichosporon aortic prosthetic graft infection has not been reported.
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.
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.
Consider T asahii in culture-negative graft infection. When explantation is unsafe, subtotal removal plus long-term azole therapy can be effective.

PMID:
42814054
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

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