Mycotic Aortic Aneurysm, a very sudden development for a preexisting Aortic Aneurysm: Case report

An Infectious Aortic Aneurysm (IAA), also known as a Mycotic Aortic Aneurysm (MAA), is a rare lesion of the aorta resulting from an infection of its wall.

A male patient in his 70s presented to our emergency department with fever, intense abdominal pain, and a pulsatile mass in the middle of the abdomen. A Computed Tomography (CT) angiography scan was done two weeks earlier and it showed a 6.6 cm subrenal aortic aneurysm. A new CT angiography scan revealed a 3.4 cm growth (10*10*9.3) with periaortic fluids. The diagnosis of MAA was considered, and emergency surgery was performed.

MAA is a rare disease characterized by a high risk of rupture and a high mortality rate, up to 43 %, despite the advances in treatment techniques. Adjacent infection is a rare cause for MAA especially on a preexisting aneurysm. The two main surgical approaches are Open Surgical Repair (OSR) and Endo-Vascular Repair (EVR). We opted for OSR with careful debridement because EVR was not available at our center and the huge size of the aneurysm posed high rupture risk.

This case demonstrates the importance of close monitoring and early intervention for aneurysms, particularly in cases with adjacent infection. Moreover, the rapid growth rate and rupture risk demands more urgent intervention if the MAA is suspected.