Mycotic aneurysm of descending thoracic aorta

Mycotic aneurysm has become rare since the introduction of penicillin. However, clinicians should be aware and consider the possibility as delayed treatment can lead to poor outcomes. We report the case of a 23-year-old Malay lady with congenital scoliosis presenting with back pain and fever. Computer tomography scan showed a large pseudo-aneurysm of descending thoracic aorta and a smaller pseudoaneurysm affecting the intercostal artery secondary to vertebral osteomyelitis. Blood culture isolated Staphylococcus aureus. She was treated with embolisation using custom-made coils and N-butylcyanoacrylate glue as temporary measure before eventually proceeding to surgery. Unfortunately, the surgery was complicated by bleeding secondary to the severely inflamed aorta resulting in her demise.