Mycotic carotid artery aneurysm.

A painful, pulsatile neck mass with associated fever should suggest the presence of a mycotic carotid artery aneurysm. Diagnosis can be confirmed from angiograms. Broad spectrum antibiotics are indicated, and an operation should be performed promptly. The lack of tissue planes uninvolved by infection will almost always prevent vascular reconstruction. Carotid artery ligation with excision of the aneurysms is recommended.