MYCOTIC-ANEURYSMS OF THE ILIAC ARTERY REV EALED BY AN ABDOMINAL-MASS

Background. Mycotic aneurysms are classic complications of infective e ndocarditis. Their diagnosis can be difficult when they are located in deep vessels. Case report. A 8 year-old boy was admitted for psoitis, tenderness of the left iliac fossa and a palpable mass. He was treate d with antibiotics for 2 months for infective endocarditis, but vomiti ng and fever began after 3 weeks of therapy. Blood cultures showed Sta phylococcus epidermidis. Ultrasonography of the mass showed findings c ompatible with an abscess but sampling of its contents showed blood. I mmediate Doppler echography showed that the mass was an aneurysm of th e left iliac artery. This diagnosis was confirmed by CT scan and aorto graphy. The aneurysm was excised and a satisfactory repair was made us ing a Gore-tex graft. Conclusion. Although this mass had no clinical v ascular characteristics, its origin should have been recognized becaus e of the history of infective endocarditis and a better analysis of th e ultrasonographic findings.