A CASE REPORT OF MYCOTIC FEMORAL ANEURYSM

A 64-year-old man was admitted to our hospital because of high fever and pain in the right groin. He had been treated for liver cirrhosis and diabetes in another hospital for several years.Nine days before his admission, he fell and bruised his right leg, and had been treated at another hospital. However, he developed a spiking fever and tender pulsatile mass in his right groin.After admission, staphylococcus epidermidis was isolated from blood culture. Sepsis was improved by intravenous antibiotics.Ultrasonography and arteriography demonstrated a saccular aneurysm of the common femoral artery. G-I series revealed esophageal varices and advanced gastric cancer. Considering potential serious complications of the mycotic femoral aneurysm, we at first performed an operation for the aneurysm. Following aneurysmectomy, resection of 4 cm of adjacent common femoral artery and a thorough debridement, an end-to-end anastomosis was performed. The postoperative course was uneventful. Two months later, he died of hepatic and respiratory failure after the subsequent gastrectomy for gastric cancer.Mycotic aneurysm is a rare arterial lesion with a high tendency for morbidity and mortality. Early diagnosis, antiseptic treatment, and proper surgical procedure are important. In this case with background factors such as liver cirrhosis and diabetes, a possible participation of decreased immunity can be thought in etiologic considerations.