Successful treatment of a mycotic multifocal thoracoabdominal aortic aneurysm as a late sequelae of intravesical bacillus Calmette-Guerin therapy: case report and literature review.
Bacillus Calmette-Guerin (BCG) is a live, attenuated strain of Mycobacterium bovis commonly used for the treatment of superficial bladder carcinoma. Intravesical BCG is well tolerated despite side effects that range from hematuria to sepsis syndrome. A very rare complication is vascular infection developing a mycotic BCG aneurysm, especially in the thoracoabdominal aorta (TAAA). These are challenging to diagnose because of their scarcity, nontraditional culture media, slow growth, and are often lethal. We report the first successful repair of a symptomatic, multifocal TAAA secondary to M bovis manifesting 17 months after intravesical BCG therapy and review the literature.
Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI.
Frank M
FM
Davis
Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI.
David J
DJ
Miller
Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI.
Duane
D
Newton
Division of Vascular Surgery and Endovascular Therapy, Emory University, Atlanta, GA.
Shipra
S
Arya
Division of Vascular Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address: gescobar@uams.edu.
Guillermo A
GA
Escobar
D000283:Administration, Intravesical; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D000995:Antitubercular Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014381:Tuberculosis, Cardiovascular / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
D000995:Antitubercular Agents; D001500:BCG Vaccine