Mycotic aneurysms in a toddler with catastrophic consequences

A male toddler presented with fever and left leg pain for 3 days, and a week later, he developed severe pain abdomen and discolouration of the right toe with absent right lower limb pulses. There was a history of burns with Pseudomonas sepsis 9 months ago and ischaemic stroke involving the left middle cerebral artery 6 months ago.On further evaluation, CT angiogram showed a saccular aneurysm involving the abdominal aorta and the right proximal external iliac artery with a thrombus extending into the distal external iliac artery. He was managed with right transiliac embolectomy, endoaneurysmorraphy, intravenous antibiotics and anticoagulation. His symptoms subsided, and on follow-up, he has recovered without major deficits.Mycotic aneurysms, though rare in children, can develop after postburn sepsis due to bacterial seeding of the vessel walls. Thrombosis is known to develop in mycotic aneurysms. Awareness about this complication of sepsis, prompt recognition and management can save the limb.