DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.053

Pages: 2417-2422

Mycotic aneurysm refers to an infection of the arterial wall caused by bacterial, fungal, or viral pathogens. Although uncommon, it represents a severe and often fatal complication of systemic infection or underlying atherosclerosis, posing significant diagnostic and therapeutic challenges. The pathogenesis involves hematogenous seeding during bacteremia, septic embolization, or direct invasion of the vessel wall, typically in patients with pre-existing atherosclerosis or immunosuppression. The aorta, intracranial arteries, and visceral or peripheral arteries are the most frequently affected sites. The natural history is characterized by progressive arterial dilation, pseudoaneurysm formation, and a high risk of rupture. Prompt recognition and management are crucial, combining targeted antimicrobial therapy with surgical or endovascular repair to optimize outcomes. We report an unusual case of a 63-year-old male with a shoulder abscess complicated by a mycotic aneurysm of the aorta and necrotizing pneumonitis, with multimodality imaging illustrating the temporal evolution of the disease.