Mycotic Aneurysm Manifesting with Life-threatening Hemoptysis-A Case Report and Literature Review

Although hemoptysis frequently occurs in a broad spectrum of diseases, hemoptysis caused by an aortic mycotic aneurysm with aortobronchial fistula is rare and seldom reported. A 77-year-old man visited our institution with fever, widened mediastinum, and massive hemoptysis; the chest images suggested a descending mycotic aortic aneurysm. An emergent operation revealed a penetrated aneurysm with adhesion to the lung parenchyma; aneurysmal resection and graft reconstruction was performed. Both the resected tissue and sputum culture grew a group D2 Salmonella strain. Six months after discontinuation of antibiotics, the patient was well without evidence of inflammation. This case is a reminder for clinicians to be alert for this rare entity when dealing with a febrile patient with hemoptysis, because the immediate implementation of management may enable the patient to survive.