Mycotic carotid aneurysm.

Mycotic aneurysms of the extracranial internal carotid artery are rare; they usually appear as an enlarging pulsatile neck mass with associated pain, tenderness, and fever. This case report illustrates the need for prompt diagnosis and urgent surgical intervention. The most common organisms found with these aneurysms have been Staphylococcus aureus and Streptococcus pyogenes. We report a case of a mycotic internal carotid artery aneurysm resulting from Salmonella enteritidis. A 20-year review of both the foreign and English language literature revealed only one other case of a mycotic carotid aneurysm resulting from Salmonella infection. The cornerstone of therapy in the past had been proximal ligation. More recently, primary reconstructive procedures with either an end-to-end anastomosis or an interposition vein graft have been described. The present case was managed with an end-to-end technique with the use of a Pruitt-Inahara shunt.