Mycotic aneurysm of the tibioperoneal Trunk. An extremely rare localization with pseudo-phlebitis clinical presentation

Since antibiotic have been widely used in the treatment of bacterial endocarditis, mycotic aneurysms caused by septic emboli have become extremely rare. We report the case of a 66-year-old male patient who presented mycotic aneurysm of the right tibioperoneal trunk two weeks after aortic and mitral valve replacement due to Enterococcus fecalis endocarditis. The clinical presentation simulated thrombophlebitis of the deep veins of right calf. A pulsating mass was diagnosed clinically and duplex ultrasound confirmed the diagnosis of a mycotic aneurysm of the tibioperoneal trunk. Surgical treatment included the closure of the orifice of the aneurysm and excision of the aneurysmal sac. Arterial reconstruction was not required. Postoperative course was uneventful. No complication was observed at long-term follow-up. This observation represents the seventh case reported in the literature of mycotic aneurysm at this localization