Gonococcal ascending aortitis with penetrating ulcers and intraluminal thrombus.

Neisseria gonorrhoeae is an uncommon pathogen causing bacterial aortitis. We describe a patient with a bicuspid aortic valve and known ascending aortic aneurysm who presented with fever and chest pain. Imaging demonstrated complex penetrating ulcers in the proximal ascending aorta. The patient underwent a modified Bentall procedure, resection of the ulcers, and ascending aortic reconstruction. Pathologic examination and culture of the aortic specimens revealed the infectious cause.