Homograft failure in mycotic aortic aneurysm caused by Streptococcus pneumoniae

Treatment of a rare Streptococcus pneumoniae mycotic aneurysm by homograft replacement failed in a 59-year-old patient because of persistent lobar pneumonia. Despite reoperation with replacement of the infected homograft by a fresh one, he finally died of septicemia. This case illustrates that homograft tissue may be infected per continuum and that extensive debridement of periaortic tissue-including major lung resection-and the use of muscle naps may be necessary in certain circumstances. (C) 1998 by The Society of Thoracic Surgeons.