LAUSR

We present the unusual case of a mycotic right common iliac artery pseudoaneurysm caused by methicillin-susceptible staphylococcus aureus (MSSA) of indeterminate etiology in a healthy 57-year-old male with no risk factors for infection, trauma or malignancy. The patient initially presented with worsening subacute right lower quadrant pain and was found to have a pseudoaneurysm of the right common iliac artery. Given concern for rupture on a computed tomography angiogram (CTA), he underwent exclusion of the pseudoaneurysm with a covered stent. At the time of presentation, he had no signs or symptoms of infection. However, the patient developed fever, chills and worsening right lower quadrant pain thirteen days following the index operation and was found to have a leukocytosis, blood cultures positive for MSSA and progressive soft tissue changes involving the right common iliac artery on CTA consistent with infection. He was definitively treated with stent explantation, aggressive debridement and replacement with an in situ cryopreserved bypass, and short-term suppressive antibiotic therapy.