Diagnostic microbiology and infectious disease
August 3, 2026 · via Europe PMC
Rupture and dissemination of a mycotic aneurysm caused by the Aspergillus fumigatus complex: A diagnostic challenge posed by a non‑sporulating isolate.
Zhang W, Wei Z, Liu Y, Xiao Y.
AI summary — for doctors, generated from the abstract only
A ruptured iliac artery mycotic aneurysm turned out to be disseminated aspergillosis caused by an atypical, non-sporulating Aspergillus fumigatus strain that was hard to recognize in culture.
What was studied
A case report of a 45-year-old man with prior lumbar tuberculosis who presented with a ruptured mycotic iliac artery aneurysm and disseminated vertebral and soft tissue lesions.
Key findings
- Intraoperative cultures grew an albino-like, slow-growing, non-sporulating A. fumigatus isolate unlike the classic phenotype
- Peripheral blood metagenomic sequencing detected A. fumigatus and serum galactomannan was markedly elevated
- Molecular sequencing identified sequence type ST26 and the multidrug resistance-associated gene ABCA
- Course was complicated by prosthetic graft infection and multiorgan dissemination
- He was treated with voriconazole plus surgical drainage and debridement, and was discharged on hospital day 58
Clinical relevance
The case illustrates that atypical, non-sporulating Aspergillus isolates may be missed on morphology, and that molecular methods and galactomannan testing can help in suspected fungal vascular infections; as a single case it does not inform treatment choices generally.
Who should care
Limitations
Single case report; long-term outcome and antifungal susceptibility results are not described in the abstract.
When a mycotic aneurysm culture looks unusual, molecular identification may be what reveals Aspergillus.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
A 45-year-old male with a history of lumbar tuberculosis presented with a ruptured mycotic iliac artery aneurysm as the initial manifestation. Imaging demonstrated aneurysm rupture with pseudoaneurysm formation and concurrent disseminated lesions involving the vertebrae and soft tissues. Intraoperative specimens grew an Aspergillus fumigatus strain that exhibited highly atypical morphology: the colonies were albino‑like, slow‑growing, and non‑sporulating, differing markedly from the classic A. fumigatus phenotype. Peripheral blood metagenomic sequencing detected A. fumigatus, and the serum galactomannan antigen was markedly elevated. Molecular sequencing confirmed the isolate as A. fumigatus sequence type ST26 and identified the multidrug resistance‑associated gene ABCA. The final diagnosis was disseminated aspergillosis presenting as a ruptured mycotic iliac artery aneurysm, complicated by prosthetic graft infection and multiorgan dissemination. The patient received systemic antifungal therapy with voriconazole, along with adequate surgical drainage and debridement. Subsequently, his inflammatory markers declined gradually, and he was discharged on hospital day 58.
DOI
10.1016/j.diagmicrobio.2026.117595
PMID
42579903
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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