Multiple pulmonary artery mycotic aneurysms and septic emboli in a patient with tricuspid valve vegetation and infective endocarditis

Mycotic pulmonary artery aneurysms are rare infectious aneurysmal dilatations of the pulmonary arteries in patients with risk factors of intravenous drug use, endocarditis, or congenital heart disease. Timely diagnosis is crucial given high mortality rate associated with this condition. We present a rare case of a 24-year old male with history of intravenous drug use who presented with fever, hypoxia, and bacteremia. The patient was subsequently diagnosed with infective endocarditis with septic vegetations of the tricuspid valve. Computed tomography angiogram demonstrated multiple bilateral mycotic pulmonary artery aneurysms and associated pulmonary septic emboli in this patient with infective endocarditis. Treatment options for mycotic pulmonary artery aneurysms are variable and include conservative management, endovascular coil intervention, or surgical resections. Presence of hemoptysis and increasing aneurysm size may warrant aggressive intervention.