Abstract
Infectious aortitis is rarely diagnosed before it becomes an infectious aortic aneurysm, and its optimal management remains less well established compared to that of infectious aortic aneurysms. We report a case of pre-aneurysmal infectious aortitis in a patient undergoing maintenance hemodialysis who presented with fever. Antibiotics were promptly initiated upon diagnosis, and the clinical course initially suggested good infection control. However, aneurysmal transformation eventually occurred, necessitating surgical intervention. This case highlights that, even in the absence of apparent clinical deterioration under antibiotics, aneurysm formation may still progress in cases of infectious aortitis. Therefore, careful and frequent imaging follow-up is essential for the early detection of aneurysmal changes.