PMC8668086_01
Lateral skull X-ray showing bony erosions (Arrow) suspicious for osteomyelitis.
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Following the biopsy results and a skull X-ray which was suspicious for osteomyelitis (Figure 1), a clinical diagnosis of MOE was made.
Non contrast CT findings (Arrow indicates the aneurysmal aortic bifurcation).
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Adjacent to the aneurysm, there was a large retroperitoneal hematoma indicative of leaking. A non-contrast CT of the abdomen confirmed the USS findings. (Figure 2) Investigations available at the time revealed a WBC count of 13.26 x 103 microL, Hb of 7.7g/dL, creatinine of 4.77mg/dL, C reactive protein level of 156mg/dL, and an ESR of 130mm in the first hour.
Intra-operative findings (Arrow indicates the aneurysmal aortic bifurcation).
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The appearance of the aneurysm was suspicious for infective arteritis. (Figure 3).