Mycotic Aortic Aneurysm With <i>Ureaplasma urealyticum</i> in a Patient With Orthotopic Heart Transplant

Mycotic aortic aneurysms (MAAs) carry a high risk for morbidity and mortality without intervention. We present a case of thoracic MAA secondary to Ureaplasma urealyticum after orthotopic heart transplant. Serial chest CTA examinations revealed a rapidly dilating ascending aorta with wall thickening and increasing number and size of irregular outpouchings. Mollicute tissue culture and broad-range PCR testing of the resected aorta were required to isolate the causative organism. To the authors' knowledge, the only other case of MAA involving U. urealyticum reported in the peer-reviewed literature involved the abdominal aorta, not the thoracic aorta.