Haemoptysis as a presentation of an infected aortic aneurysm rupture

Infective thoracic aortic aneurysms are uncommon, especially presenting with haemoptysis.

We report the case of an 81-year-old male who presented with fever and pleuritic chest pain and was initially misdiagnosed with community-acquired pneumonia. A CT scan later  revealed a saccular, ruptured thoracic aortic aneurysm. Despite antibiotic therapy, the patient developed haemoptysis, necessitating thoracic endovascular aortic repair (TEVAR). Post-procedure, the patient showed significant clinical improvement and was discharged in stable condition 45 days later.

Infected thoracic aortic aneurysms presenting as haemoptysis are exceptionally rare but life-threatening. Early clinical suspicion (manifested by haemoptysis, fever and thoracic pain) is essential, particularly in patients with risk factors such as immunosuppression or previous infections. This case emphasizes the importance of prompt diagnosis and intervention, along with the use of appropriate imaging techniques to reduce morbidity and mortality associated with this rare yet severe condition.