This is an unusual case of a mycotic aortic aneurysm located in the ascending aorta caused by Neisseria meningitidis. The diagnosis was made using two-dimensional (2D) and three-dimensional (3D) transoesophageal echocardiogram (TOE) and cardiovascular magnetic resonance (CMR). Management was with prolonged antibiotics followed by surgical resection. The ascending aorta was replaced with Dacron tube graft. The contribution of multimodality imaging in clearly defining the pathology, its location and directing the timing of surgery, was a striking aspect of this case.
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