Rupture of a cervical carotid artery aneurysm is a rare but life-threa
tening event. The diagnostic evaluation and therapeutic management of
a 55-year-old woman with such a lesion are described. In this case, th
e aneurysmal rupture was complicated by localized Staphylococcus aureu
s infection confirmed by bacteriologic culture of excised tissue, sept
icemia, and prevertebral and intraspinal abscess. Definitive diagnosis
was a ruptured mycotic aneurysm of the extracranial carotid artery. T
he origin of the infection was probably the patient's previously infec
ted vascular prosthesis for hemodialysis.