Mycotic popliteal artery aneurysm due to exostosis treated by excision and bypass

Hereditary exostosis is an autosomal-dominant condition characterized by multiple osteochondromas. A 54-year-old woman presented with 2 months of myalgias, fevers, and deep bone pain in her right lower extremity. Computed tomography angiography demonstrated a 6 × 4 cm popliteal artery aneurysm. She underwent femoral to popliteal artery bypass with the greater saphenous vein. Intraoperatively, a bony prominence was seen protruding into the aneurysm sac and resected. Blood cultures grew Streptococcus mitis, a common oral microbe that may have translocated after dental cleaning. The patient recovered well with a patent bypass and normal PVR at the 2-year follow-up.