Mycotic Pseudoaneurysm of the Internal Carotid Artery After a ‘Common Cold’: A Rare Case Report

Abstract

Introduction

We present a rare case of mycotic pseuodaneurysm in elderly patient following a previously untreated upper respiratory tract infection.

Case Report

A 78 year old gentleman complaining of hoarseness and abrupt formation of pulsatile neck mass was admitted to vascular surgery department. Three weeks earlier he exprienced symptoms of upper respiratory tract infection (“common cold”) for which he did not seek medical attention. A contrast computed tomography scan (CT) revealed pseduoaneurysm of left internal carotid artery (ICA) compressing the laryngeal wall. Surgical excision of the pseudoaneurysm was performed with restoration of blood flow using a saphenous vein graft interposition. Microbilogical report confirmed bacterial infection caused by Pseudomonas oryzihabitans.

Discussion

Mycotic pseudoaneurysms of the extracranial ICA are rare and challenging to manage. In our case, presumed mechanism of pseudoaneurysm formation was direct microorganism invasion of arterial wall via periarterial lymphatics and vasa vasorum. To our knowledge, this is the first reported case describing the opportunistic bacterium Pseudomonas oryzihabitans as a causative agent.