Reported here is the case of an 82-year-old man with underlying atherosclerotic vascular disease who developed an aortic pseudoaneurysm following Streptococcus pneumoniae bacteremia. The patient experienced severe midthoracic back pain in association with fever, chills, leukocytosis, and an elevated erythrocyte sedimentation rate. Computed tomography revealed a pseudoaneurysm of the descending thoracic aorta with displacement of intimal calcification, which was likely due to infection and subsequent ulceration of an atheroscle rotic plaque from preceding S. pneumoniae bacteremia. The patient declined surgical inter vention and, despite antibiotic therapy, died shortly after presentation.
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