# Neoaortoiliac reconstruction for a Histoplasma capsulatum endograft infection

## TL;DR

A man with a history of aortic aneurysm repair developed a rare fungal infection in his graft, which was successfully treated with a new surgical procedure and antifungal therapy.

## Contribution

The case highlights the effectiveness of neoaortoiliac reconstruction combined with antimicrobials for treating Histoplasma capsulatum graft infections.

## Key findings

- Neoaortoiliac system procedure using autologous femoral veins was effective in treating a Histoplasma capsulatum endograft infection.
- Continued outpatient itraconazole therapy supported successful management of the complex infection.
- The case emphasizes the importance of considering fungal pathogens in graft infections.

## Abstract

We present a case of a 64-year-old man with a history of endovascular abdominal aortic aneurysm repair endovascular aneurysm repair in 2015, who developed a graft infection owing to Histoplasma capsulatum in 2025. The patient underwent a neoaortoiliac system procedure using autologous femoral veins for reconstruction with continued itraconazole therapy in the outpatient setting. This case underscores the importance of considering fungal pathogens in graft infections and highlights the effectiveness of the neoaortoiliac system procedure in conjunction with antimicrobials in managing such complex cases.