To report a clinical case of mycotic thoracic aortic aneurysm. To describe and illustrate the spectrum of MDCT findings, analysing the pathophysiology, diagnostic evaluation and therapeutic management. To emphasis the early non-invasive diagnosis as a way to overall survival improvement. A mycotic aneurysm is an uncommon vascular lesion resulting from arterial wall destruction by infection, generally involving the peripheral arteries or aorta and rarely the cerebral and visceral arteries. Defined as a lobulated saccular outpouching of the wall communicating with the lumen, it is surrounded by oedema, hematoma and/or fibro-inflammatory tissue. Due the non-specific and delayed - or even absent - manifestations, a high degree of clinical suspicion is necessary to achieve a timely treatment and prognosis improvement. In this setting, radiologic evaluation - mainly by MDCT angiography - is essential, allowing detection, characterization and complications assessment before treatment planning.

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