Graft Infection of Thoracic Aorta Due to Group C b-Hemolytic Streptococcus

A fatal case of late-onset graft infection of the thoracic aorta due to group C b-hemolytic streptococcus is described. A 37-year-old male patient, who had a history of total aortic arch replacement for acute aortic dissection 8 years before, was admitted to the department. He suffered from toxic shock syndrome, disseminated intravascular coagulation (DIC), and acute renal failure. Group C b-hemolytic streptococcus was detected from his blood; however, echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) failed to detect the focus of the infection. In spite of intensive care, including antibiotic therapy, artifi-cial ventilation, and continuous hemodiafiltration, he died on the 18th day of hospitalization. Autopsy revealed that a small abscess was present at the proximal anastomotic segments of the patient’s graft. A bite inflicted by his dog, 14 days before admission, was suspected to be the source of this bacterium. A rare case of graft infection of thoracic aorta in terms of causative organism, long period from graft replacement to graft infection, and site of infection is presented and discussed