CTICasesMycotic Aneurysm (Streptococcus pneumoniae Aortitis)
Imaging findings
Radiograph demonstrates an abnormal, irregular contour of the descending thoracic aorta and aortic arch. Contrast-enhanced CT reveals a large, lobulated, mushroom-shaped pseudoaneurysm arising from the descending thoracic aorta with surrounding inflammatory soft tissue thickening.
Key takeaways
A mycotic aneurysm is a life-threatening, focal infectious pseudoaneurysm of the aorta, often classically shaped like a mushroom (which originally inspired the term "mycotic," rather than a fungal etiology). While Streptococcus pneumoniae is an uncommon cause of infectious aortitis compared to Salmonella or Staphylococcus aureus, it can lead to rapid arterial wall destruction and catastrophic rupture if not surgically resected and treated with targeted antibiotics.
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