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.