Abstract
A 64-year-old man presented with abdominal bloating and a fever. Initial imaging revealed an abdominal aneurysm suspected to be an infected aortic aneurysm (IAA); therefore, antibiotic treatment was initiated. Blood culture confirmed group A Streptococcus (GAS). Follow-up computed tomography revealed aneurysm expansion, confirming the diagnosis of IAA. The patient survived the emergency surgery. IAA is a potentially fatal disease with a high risk of rupture. IAA is rarely caused by GAS and is a diagnostic challenge owing to non-specific symptoms and imaging findings. We herein review reports of GAS-caused IAA and highlight diagnostic and therapeutic dilemmas, including the optimal timing for surgery, which warrants further research.