Latent mycobacterium avium infection causing a mycotic suprarenal aortic aneurysm in a human immunodeficiency virus-positive patient

Mycobacterium avium complex (MAC) infection occurs in up to 50% of advanced-stage human immunodeficiency 1 (HIV-1) infections when the CD4 counts is <50/mm³. We report the case of a 52-year-old HIV-positive patient who presented with a symptomatic, rapidly growing suprarenal abdominal aortic aneurysm. He had been diagnosed and treated for disseminated MAC infection 3 years earlier. He was treated with antiretroviral medications and had a CD4 count >250 cells/mm³ and an undetectable viral load. Open repair was performed using cryopreserved homograft. Microbiologic cultures from the specimen revealed infection with mycobacterium avium. This is the first case to report a mycotic suprarenal aortic aneurysm caused by an active conversion of a latent MAC infection.