Mycotic aneurysm of the extracranial carotid artery: a case report and review of the literature.

Aneurysm of the extracranial carotid artery is a rare condition; mycotic aneurysms are even less common. They always need surgical treatment to prevent possible rupture, embolisation or death. The literature before 1980 mentions ligation as the only treatment for mycotic aneurysms of the carotid artery, obviously with a high morbidity and mortality rate. We describe an 85-year-old male with a left carotid artery mycotic aneurysm. He presented with a history of Transient Ischaemic Attack (TIA) four weeks after a gastrointestinal infection. Resection of the aneurysm and interposition with autologous vein was performed. Escherichia coli was isolated from the excised tissue. Primary resection of the aneurysm with autologous vein interposition, in association with prolonged antibiotic therapy, is the preferred strategy. Prompt diagnosis and aggressive treatment is essential to prevent serious complications.