title: Mycotic abdominal aortic aneurysm after adjuvant therapy with bacillus Calmette-Guérin in patients with urothelial bladder cancer: a rare but misinterpreted complication.
abstract: Bacillus Calmette-Guérin (BCG) therapy is often associated with side effects. The most feared is disseminated sepsis that may occur rarely with the development of mycotic aortic aneurysms. Twenty cases of patients treated with intravesical BCG complicated by mycotic abdominal aortic aneurysm have been reported in the literature, including 2 cases of the present study. Delayed vascular work-up represents a critical aspect. Mycotic aneurysms evidence a rapid progression. Primary care physicians and urologists should be sensitized to recognize unspecified symptoms such as potential clinical manifestations of a mycotic abdominal aortic aneurysm, even several months or years after BCG therapy.
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy. Electronic address: e.leo@ospedale.lecco.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Leo
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Alessandro L C
authors.initials: AL
authors.lastname: Molinari
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Ferrari
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Terzi
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lorenzi
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000995:Antitubercular Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001019:Aortic Rupture / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*; D019459:Urothelium / Q000473:pathology
chemical_list: D000995:Antitubercular Agents; D001500:BCG Vaccine