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Mycotic Aneurysm of a Persistent Sciatic Artery Mayu Hikone, Kenichi Ariyada and Ken-ichiro Kobayashi Key words: mycotic aneurysm, persistent sciatic artery, methicillin-resistant Staphylococcus aureus

(Intern Med 56: 239, 2017) (DOI: 10.2169/internalmedicine.56.7489)

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An 83-year-old febrile woman presented with leg pain. Her lateral right thigh was swollen, but no neurological or ischemic findings were noted. A computed tomography scan showed an abnormal right internal iliac artery leading directly into the posterior aspect of the thigh, which was determined to be a persistent sciatic artery (PSA) (Picture). The PSA was thrombosed, dilated, and surrounded by enlarged multiple nodular aneurysms, with irregular wall thickening and perivascular edema indicative of infection. Methicillin-resistant Staphylococcus aureus (MRSA) was detected from blood cultures, and an MRSA mycotic aneurysm of a PSA was diagnosed. Her symptoms resolved gradually with intravenous vancomycin. Oral antibiotics were unavailable, so she remains under close observation after 12 weeks of treatment. Aneurysmal enlargement and thromboembolism of a PSA may bring about complications such as limb ischemia and neuralgia (1). The development

of a mycotic aneurysm of the type we encountered is notably rare (2). The authors state that they have no Conflict of Interest (COI).

References 1. Patel MV, Patel NH, Schneider JR, Kim S, Verta MJ. Persistent sciatic artery presenting with limb ischemia. J Vasc Surg 57: 225229, 2013. 2. Ito S, Kowatari R, Konishi T, Imazuru T, Matsuzaki K, Jikuya T. Thrombosed infectious aneurysm of the left persistent sciatic artery. Jpn J Vasc Surg 22: 73-76, 2013. The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/ by-nc-nd/4.0/).

Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Japan Received for publication April 4, 2016; Accepted for publication May 23, 2016 Correspondence to Dr. Mayu Hikone, [email protected] Ⓒ 2017 The Japanese Society of Internal Medicine Journal Website: http://www.naika.or.jp/imonline/index.html

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Mycotic Aneurysm of a Persistent Sciatic Artery.

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