Mycotic Aneurysm of the Carotid Bifurcation Secondary to Pseudomonas Infection

Abstract

Mycotic aneurysms of the extra-cranial carotid artery are rare in clinical practice. Trauma, atherosclerotic disease, and a prior history of carotid surgery are common predisposing factors. Staphylococcus and Streptococcus species are most often found, with additional reports in the literature of various gram negative rods. These lesions are secondary to bacteremic episodes or extension of local infection. Patients present with tender, enlarging neck masses and fever. Treatment involves debridement of all infected tissue, reconstruction with autologous material, if possible, and long-term culture-determined antibiotic therapy. The authors present a unique case of a mycotic carotid aneurysm secondary to Pseudomonas infection following a tooth extraction.