Mycotic Pseudoaneurysm of the Tibioperoneal Trunk and Posterior Tibial Artery

Mycotic aneurysms are an uncommon complication of infective endocarditis. Aneurysms located in the infrapopliteal arteries are very rare. We report a case of a 37-year-old male patient presenting cough, fever, night sweats, shortness of breath and weight loss, who acutely developed a sharp pain and edema in his right calf, firstly diagnosed as a deep venous thrombosis. Further investigation of his symptoms identified its etiology as an infective endocarditis. Antibiotic therapy was initiated. However, the patient’s clinical condition deteriorated and he was submitted to an aortic valve and a mitral replacement successfully. The leg pain and edema persisted after the surgical procedure and the investigation continued. A Doppler ultrasound test and an angiography revealed a pseudoaneurysm located in the right tibioperoneal trunk and in the upper third of the posterior tibial artery. The pseudoaneurysm was treated through endovascular percutaneous embolization and with two Gugliemi detachable coils