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 flaps may be necessary in certain circumstances.