Abstract
Mycotic pseudoaneurysms are rare infectious complications that may involve the aorta, peripheral arteries, cerebral arteries, or visceral arteries. We present a unique case of thoracoabdominal mycotic pseudoaneurysm secondary to hematogenous spread of Streptococcus pneumoniae from spinal osteomyelitis. The infections started with bacterial translocation to the calcified ostial plaque around the celiac origin, which then degenerated into a rapidly growing pseudoaneurysm. Our approach involved open repair with a femoral vein patch and pedicled omental flap. The patient recovered well postoperatively with complete resolution of the aneurysm on follow-up imaging.