A Rare Case Giant Infected Aneurysm in a 51-Year-Old Woman with History of Left Ear Pain, Facial Drooping, and Ear Surgery Revealed by Computed Tomography

Abstract

Infected aneurysms, though rare, present significant challenges in contemporary medical practice. Coined by Sir William Osler in 1885, the term “mycotic aneurysm” encompasses infections of native arteries and preexisting aneurysms, posing life-threatening risks of arterial rupture and recurrence. We discuss a case involving a 51-year-old woman with a giant infected aneurysm, highlighting the complexities in diagnosis. The patient presented with bleeding from her left ear, a fluctuating neck mass, and decreased hearing. Contrast-enhanced computed tomography (CT) played a crucial role in revealing the infected giant aneurysm in the left internal carotid artery, associated with arteriovenous malformation and fistula. Additionally, incidental findings included aneurysms in the right internal carotid and bilateral vertebral arteries. The case underscores the importance of a high index of suspicion and advanced diagnostic tools for timely and accurate diagnosis. The rarity of experienced centers in managing such cases, coupled with a lack of consensus in diagnostic criteria, poses challenges for treatment improvements.