The dove of peace is not peaceful : the ghost of aortic arch pseudoaneurysm

Infectious pseudoaneurysms are rare, and those caused by Cryptococcus, an organism commonly found in pigeon feces, are exceptionally uncommon. This case highlights this severe vascular complication as a sequel of cryptococcal infection. A 71-year-old male with a history of pigeon exposure presented with a persistent fever and was diagnosed with cryptococcal pneumonia and bacteremia. After successful initial antifungal treatment, a follow-up chest CT scan three months later revealed a pseudoaneurysm at the aortic arch. The patient underwent successful endovascular repair with a covered stent, achieving a satisfactory outcome. This case demonstrates that cryptococcal infection can lead to the serious complication of an aortic pseudoaneurysm, which may develop or be detected after the initial infection. It underscores the importance of long-term monitoring in patients with cryptococcemia and highlights the need for awareness of this risk in individuals exposed to pigeons.