F-18 FDG PET-CT imaging of a mycotic aneurysm

We present a case of a 74-year-old man with a history of a known 4.3-cm abdominal aortic aneurysm (AAA) and recent sigmoid colectomy for colon cancer who presented with Staphylococcus aureus bacteremia, renal failure, and low-grade fever. The likely source of his bacteremia was an infected AAA, seeded hematogenously at the time of surgery. This diagnosis was confirmed by several different imaging modalities to include computerized tomography (CT), magnetic resonance imaging (MRI), indium-111 labeled white blood cell single-photon emission computed tomography (WBC-SPECT), and F-18 FDG positron emission tomography (PET). We demonstrate concordance among these modalities, including PET-CT, the newest addition to the mycotic aneurysm diagnostic armamentarium.