Background: Mycotic aortic aneurysm (MAA) is a rare clinical entity with an incidence of 1-3%, but it is a life-threatening
infection of aorta characterized by dilatation of aorta with false lumen. Multiple MAAs have been reported rarely with an
incidence of 0.03% and associated with a high mortality rate of 80% if ruptured.
Case presentation: A hypertensive and diabetic 78-year-old man visited our emergency department complaining
intermittent dull and tingled pain over the left flank region for 1 week. Chest X-ray showed left pleural effusion and
hemothorax was confirmed by thoracocentesis. Computed tomography (CT) of chest demonstrated multiple thoracic
aortic aneurysms and the pathological findings disclosed the diagnosis of multiple MAAs. He was discharged under an
uneventful condition post-surgical aortic repair with adequate intravenous antibiotics for 4 weeks.
Conclusions: CT scan may make a definite diagnosis of multiple MAAs and management with surgical debridement,
aortic repair and full-course antibiotics for Gram-positive coccus and/or Gram-negative bacillus is recommended.
