Purulent bloody drainage after infected total hip arthroplasty: a sign of a leaking mycotic aneurysm.

An infected total hip arthroplasty remains one of the most challenging problems faced by orthopaedic surgeons from diagnosis through treatment. We present the case of a 58-year-old woman who was referred to our service with an infected revision total hip arthroplasty. The hip had migrated medially, and the patient had recently noted the presence of blood discharging through a chronic sinus. Angiography revealed a mycotic aneurysm of the external iliac artery. An emergency procedure incorporating a femorofemoral bypass graft and a Girdlestone procedure was undertaken. This is the first reported case of a leaking mycotic aneurysm presenting acutely with blood discharging through a previously chronically discharging sinus tract.