Related Experiment Video
Updated: Jul 3, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Common Iliac Artery Mycotic Pseudoaneurysm Associated with a Prevertebral Infection: A Case Report
Will Davis1, Christopher Greene1, Brendan Anzalone1
1University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama.
Introduction:
Mycotic pseudoaneurysms are rare but severe sequelae of an arterial wall infection. If undiagnosed and untreated they can lead to significant morbidity and mortality through complications such as arterial rupture or dissection.
Case Report:
This report details the case of a 64-year-old-male who developed a left common iliac artery mycotic pseudoaneurysm from Proteus mirabilis, which was associated with a prevertebral abscess. The patient presented with isolated, left lower extremity edema and intermittent fevers. The case is unique in both the pathogen (P mirabilis) and in its association with presumed direct arterial wall infection from an adjacent prevertebral abscess.
Conclusion:
The obscure presentation highlights the need for a high clinical suspicion of such a diagnosis when a patient presents with a certain constellation of symptoms and the right predisposing risk factors in their history.
Insights
Mycotic pseudoaneurysms, rare arterial infections, can cause severe complications. This case highlights a unique presentation of a Proteus mirabilis infection in the iliac artery, emphasizing the need for clinical suspicion.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Radiology
Background:
- Mycotic pseudoaneurysms are uncommon but serious arterial infections.
- Untreated cases lead to high morbidity and mortality from rupture or dissection.
Purpose of the Study:
- To report a unique case of a mycotic pseudoaneurysm.
- To highlight diagnostic challenges and clinical considerations.
Main Methods:
- Case report of a 64-year-old male.
- Detailed clinical presentation, diagnostic workup, and management.
Main Results:
- A left common iliac artery mycotic pseudoaneurysm caused by Proteus mirabilis was identified.
- The pseudoaneurysm was associated with a prevertebral abscess.
- Patient presented with lower extremity edema and fevers.
Conclusions:
- This case is unique due to the pathogen (Proteus mirabilis) and its association with a prevertebral abscess.
- Emphasizes the importance of high clinical suspicion for mycotic pseudoaneurysms with specific symptoms and risk factors.
