Phytotic (Mycotic) Intracranial Aneurysm With an Unusual Pathogenesis

Aneurysms which are formed when the wall of an artery is weakened from within by infection are generally called "mycotic" even though the most common infection is by pyogenic bacteria rather than by fungi. This report documents the unusual and unexpected postmortem finding of an awn of a grass inflorescence as the nidus for the pathogenesis of a mycotic aneurysm of the right middle cerebral artery. Such an etiology should typically be termed "phytotic." Case Summary A previously healthy 5½-year-old boy was treated for otitis media three weeks prior to admission. This responded to a combination of intramuscularly and orally administered antibiotics.