Infected vascular grafts with aortoenteric fistulae can be difficult to diagnose. We describe an interesting patient who developed hypertrophic osteoarthropathy of the lower extremities. This occurred one year prior to the diagnosis of an infected vascular prosthesis. With definitive surgical therapy, all symptoms of hypertrophic osteoarth ropathy resolved. Patients with arterial prostheses who present with hypertrophic osteoarthropathy should be carefully evaluated for occult graft infections.
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