Case Report: Left Vocal Cord Palsy and Hoarseness—A Case of Mycotic Arch Aneurysm With Infective Endocarditis

We present contrast‐enhanced CT images of the neck and chest from a gentleman in his 70s who presented with fever, malaise, and left knee pain. He was diagnosed with septic arthritis and Staphylococcus aureus bacteremia. During admission, he developed new‐onset hoarseness. Flexible laryngoscopy confirmed left vocal cord palsy. CT neck and thorax with contrast revealed a saccular aneurysm of the aortic arch (Standring, 2020; Netter, 2022; Paquette et al., 2012). Urgent surgical repair revealed an aortic abscess with rupture into the pericardial cavity. He was treated for infective endocarditis with intravenous flucloxacillin. Postoperatively, he developed a superficial sternotomy wound infection due to Candida albicans , successfully managed with fluconazole and negative‐pressure wound therapy. Follow‐up CT angiogram confirmed stability of the repaired aortic arch (Standring, 2020; Netter, 2022; Paquette et al., 2012). Ongoing dysphonia raised concern for persistent left recurrent laryngeal nerve palsy, prompting SALT referral for rehabilitation.