Unusual Complicated Fungal Endocarditis in a Patient With Vascular Ehlers-Danlos Syndrome

Abstract

A 24-year-old man with dilated aortic root and vascular type Ehlers-Danlos syndrome underwent aortic root replacement with a stentless bioprosthesis. A year later he developed aortic valve endocarditis necessitating a redo valve replacement. Excised valve tissue grew fungus Purpureocillium lilacinum. Over a period of 4 years the case was further complicated with mycotic aneurysm of the infrarenal aorta, a retroperitoneal abscess (treated surgically), a right common iliac aneurysm, right lower limb emboli (femoral embolectomy and left-to-right femoral bypass was performed), 2 false aneurysms of the ascending aorta with a large mobile mass attached to the anterior aneurysm, and brain abscesses.