Mycotic aortic aneurysm as a postsurgical complication: report of a case and review of the literature

Document Type : Case Report


Radiologist, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Mycotic aneurysms are localized and irreversible dilatations of the arteries caused by
weakening and damaging the arterial wall by an invasive organism establishing
infective arteritis. Mycotic aneurysm of the thoracic aorta is a rare event;
however, it can be fatal if not diagnosed early or not treated appropriately.
Clinical findings are usually nonspecific; however, contrast-enhanced computed
tomography (CT) is a common imaging modality of choice for the detection of
mycotic aneurysms. Current management consists of antibiotic therapy and
surgical treatment or endovascular interventions as early as possible. Herein,
we present a case report of mycotic aneurysm of the thoracic aorta as a
postoperative complication in a 60-year-old female with a clinical history of
the cardia and esophageal carcinoma who underwent thoracic surgery. The
presence of mycotic aneurysm was detected after performing a contrast-enhanced
thoracic CT scan


1. Parkhurst GF, Dekcer JP. Bacterial aortitis and mycotic aneurysm of the aorta; a report of twelve cases. Am J Pathol. 1955; 31:821-35.
2. Muller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg. 2001; 33:106-13. 
3. Dolapoglu A, de la Cruz KI, Coselli JS. Management of a mycotic thoracoabdominal aortic aneurysm involving the celiac artery. Texas Heart Inst J. 2016; 43:528-30.
4. Osler W. The Gulstonian lectures on malignant endocarditis. Br Med J. 1885; 1:577-9.
5. Fisk M, Peck LF, Miyagi K, Steward MJ, Lee SF, Macrae MB, et al. Mycotic aneurysms: a case report, clinical review and novel imaging strategy. QIM. 2012; 105:182-8.
6. Tsao JW, Marder SR, Goldstone J, Bloom AI. Presentation, diagnosis, and management of arterial mycotic pseudoaneurysms in injection drug users. Ann Vasc Surg. 2002; 16:652-62.
7. Lee WK, Mossop PJ, Little AF, Fitt GJ, Vrazas JI, Hoang JK, et al. Infected (mycotic) aneurysms: spectrum of imaging appearances and management. Radiographics. 2008; 28:1853-68.
8. Oderich GS, Panneton JM, Bower TC, Cherry KJ Jr, Rowland CM, Noel AA, et al. Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg. 2001; 34:900-8.
9. Gross C, Harringer W, Mair R, Wimmer-Greinecker G, Klima U, Brucke P. Mycotic aneurysms of the thoracic aorta. Eur J Cardiothorac Surg. 1994; 8:135-8.
10. Macedo TA, Stanson AW, Oderich GS, Johnson CM, Panneton JM, Tie ML. Infected aortic aneurysms: imaging findings. Radiology. 2004; 231:250-7.
11. Moriarty JA, Edelman RR, Tumeh SS. CT and MRI of mycotic aneurysms of the abdominal aorta. J Comput Assist Tomogr. 1992; 16:941-3.
12. Sorelius K, di Summa GP. On the diagnosis of mycotic aortic anevrysms. Clin Med Insights Cardiol. 2018; 12:117954818759678.
13. Hsu RB, Chang CI, Wu IH, Lin FY. Selective medical treatment of infected aneurysms of the aorta in high risk patients. J Vasc Surg. 2009; 49:66-70.
14. Aoki C, Fukuda W, Kondo N, Minakawa M, Taniguchi S, Daitoku K, et al. Surgical management of mycotic aortic aneurysms. Ann Vasc Dis. 2017; 10:29-35.
15. Clough RE, Black SA, Lyons OT, Zayed HA, Bell RE, Carrell T, et al. Is endovascular repair of mycotic aortic aneurysms a durable treatment option? Eur J Vasc Endovasc Surg. 2009; 37:407-12.