Suprainguinal Vascular Pythiosis: Effective Long-term Outcome of Aggressive Surgical Eradication

Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum , has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thal...

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Bibliographic Details
Published inAnnals of vascular surgery Vol. 28; no. 7; pp. 1797.e1 - 1797.e6
Main Authors Hahtapornsawan, Suteekhanit, Wongwanit, Chumpol, Chinsakchai, Khamin, Hongku, Kiatisak, Sermsathanasawadi, Nuttawut, Ruangsetakit, Chanean, Mutirangura, Pramook
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Inc 01.10.2014
Subjects
Adult
Amputation
Antifungal Agents - therapeutic use
Combined Modality Therapy
Diagnosis, Differential
Groin - blood supply
Groin - surgery
Humans
Leg - blood supply
Leg - surgery
Male
Pythiosis - diagnosis
Pythiosis - drug therapy
Pythiosis - surgery
Surgery
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Summary:Vascular pythiosis, a vascular infectious disease in hemoglobinopathy patients, caused by Pythium insidiosum , has an endemic area in tropical and subtropical countries. According to literature review, suprainguinal vascular pythiosis leads to 100% of mortality. The authors report a 35-year-old thalassemic patient who presented with a right inflammatory pulsatile groin mass and right limb ischemia. The computerized tomography angiography indicated a false aneurysm at the right external iliac artery and thrombosed entire right leg arteries. The management comprised antifungal agent, immunotherapy, and surgical removal of all infected arteries (high up to the right common iliac artery and above-knee amputation). The patient was found in a good condition at 36 months after the follow-up period.
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ISSN:0890-5096
1615-5947
DOI:10.1016/j.avsg.2014.04.020