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Extracranial carotid artery aneurysms are a rarely reported entity. Here, we describe an unusually large internal carotid artery aneurysm in a 76-year-old female, with progressive enlargement and history of thromboembolic event. She was managed successfully with an open repair and common carotid artery to internal carotid artery bypass.

Mycotic aneurysms, often saccular, accounting for approximately 2.5% of all abdominal aortic aneurysms, possess increased risk of rupture, uncontrolled sepsis, and protracted hospital stay and are associated with high morbidity and mortality. The authors report the case of a 49-year-old female with no known comorbidities who presented with free rupture of an infrarenal dissecting mycotic aneurysm and underwent emergent open repair successfully. The etiological agent, Brucella melitensis, a Gram-negative zoonotic coccobacillus, is rarely reported to cause mycotic aneurysm.

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