Imminent Rupture of an Infected Aortic Aneurysm Presenting as Lower Back Pain in an Elderly Patient.

An infected abdominal aortic aneurysm (IAAA) is a rare and potentially life-threatening condition that can mimic common spinal disorders, leading to delayed diagnosis. We report a case of a 63-year-old male who presented with lower back pain and left leg numbness. Initially suspected to have a spinal pathology, further investigation revealed an IAAA complicated by a psoas abscess and septic shock. Despite initial antibiotic therapy, the aneurysm ruptured, necessitating emergency surgical intervention. Unfortunately, the patient died from circulatory failure on postoperative day four. This case highlights the diagnostic challenges of IAAA, particularly in patients presenting with nonspecific back symptoms. Clinicians should maintain a high index of suspicion for IAAA in elderly patients with back pain and signs of systemic infection, and imaging should be carefully reviewed beyond musculoskeletal structures.