Abstract
A 76 year old diabetic man presented with a rapidly growing (over two weeks) pulsatile mass on the left foot, with no history of trauma (A, arrow). Duplex ultrasonography revealed a 32 × 17 mm dorsalis pedis artery pseudoaneurysm, the diagnosis confirmed by whole body computed tomography angiography (B, arrow). Blood cultures revealed a non-enterococcal group D streptococcal bacteraemia secondary to periodontitis. Mycotic pseudoaneurysm was suspected. Intravenous amoxicillin followed by oral amoxicillin–clindamycin for a six week total duration were given. Because of the pseudoaneurysm location and risk of ischaemia, surgery was not performed. The pseudoaneurysm was treated successfully by ultrasonographically guided thrombin injection without ultrasound recurrence at one year.Image 1
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