Multiple mycotic aneurysms due to Mycobacterium bovis after intravesical bacillus Calmette-Guérin therapy.
Mycotic aneurysms are exceptional complications after intravesical instillations of bacillus Calmette-Guérin (BCG) for bladder carcinoma. We report a patient who underwent an emergency operation for a ruptured carotid aneurysm 16 months after BCG therapy. Postoperative investigations discovered multiple other synchronous aneurysms. Culture of an abscess surrounding the right carotid artery identified Mycobacterium bovis var BCG. The patient improved clinically with antituberculous agents prescribed for 9 months but died from recurrence of bladder carcinoma 16 months later. A mycotic origin should be evoked when an aneurysm is discovered after BCG therapy. Microbiologic investigation of the artery wall is diagnostic.
Coscas
Raphael
R
Department of Cardiovascular Surgery, Faculté de Médecine Paris Descartes et Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.
Arlet
Jean-Benoît
JB
Belhomme
Denis
D
Fabiani
Jean-Noël
JN
Pouchot
Jacques
J
D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D002278:Carcinoma in Situ / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014381:Tuberculosis, Cardiovascular / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D000995:Antitubercular Agents; D001500:BCG Vaccine