External carotid artery aneurysms are rare, and mycotic involvement is even more uncommon. 4re, we present a 65-year-old man who developed a rapidly enlarging mycotic superficial temporal artery aneurysm two years after blunt trauma.Initial imaging showed only a minor temporal bone fracture.During a 2023 hospitalization for small bowel obstruction complicated by ileus, intubation, and empiric antibiotics, MRI revealed a 1.85-cm STA aneurysm, which enlarged to 2.69 cm during a later admission.He presented with rapid expansion and skin breakdown and underwent urgent open excision followed by culture-directed oral antibiotics for 2 weeks resulting in complete resolution.
Maza et al. (2026) studied this question.