Extra-Aortic Mycotic Aneurysm Due to Group A Streptococcus after

Mycotic aneurysms, especially outside the aorta, are uncommon, with group A Streptococcus a particularly rare cause. We report a case of extra-aortic mycotic aneurysm following a sore throat without demonstrable bacteremia where identifica-tion of the pathological organism was made by molecular diagnostic techniques after a standard laboratory culture was negative. A 58-year-old man was transferred to a tertiary vascular centerfrom a district hospital. Ten days before admission, he had consulted his general practitioner because of a sore throat and was found to have an erythematous throat with tender cervical lymph-adenopathy on examination. He was given a 7-day course of phe-noxymethylpenicillin at 500 mg four times a day, but a throat swab was not taken at the time. Three days before admission, he had developed pain in his left groin, which increased in intensity and progressed to involve the thigh and left side of his abdomen. On the day of admission, anesthesia in the area innervated by the left anterior femoral cutaneous nerve and some mild left leg weakness had developed, impeding his mobility