Descending thoracic aortic aneurysm complicated with severe vertebral erosion

We describe a case of successful surgical treatment for mycotic thoracic aortic aneurysm with vertebral erosion. A 70-year-old man presented with a 2 month history of back pain. Chest roentgenography and enhanced computed tomography showed a descending thoracic aortic aneurysm with destruction of T8-T10 vertebrae. We suspected that the formation of pseudoaneurysms was due to direct extension of tuberculous vertebral, osteomyelitis. He was managed with a combination of surgery and antituberculous chemotherapy. No causative pathogen was identified from specimens obtained perioperativety. The postoperative course was uneventful and he remained well 2 years later. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.