Neoaortoiliac reconstruction for a Histoplasma capsulatum endograft infection

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 <i>Histoplasma capsulatum</i> 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.