title: Massive Hemoptysis From an Aortobronchial Fistula Secondary to BCG-Related Mycotic Thoracic Aortic Aneurysm.
abstract: Intravesical bacillus Calmette-Guérin (BCG) is first-line therapy for noninvasive bladder cancer. Although side effects are rare, systemic dissemination can result in mycotic aneurysms. We report the case of a rapidly developing thoracic aortic mycotic aneurysm presenting as massive hemoptysis from an aortobronchial fistula. This case was unusual in its location, rapidity of development, and failure of medical therapy. The diagnostic challenges and the need for a high index of suspicion are discussed.
authors.affiliation: Center for Comprehensive Cardiovascular Care, Saint Louis University School of Medicine, Saint Louis, Missouri. Electronic address: huids@slu.edu.
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Hui
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: David A
authors.initials: DA
authors.lastname: Stoeckel
authors.affiliation: Southern Illinois Healthcare, Carbondale, Illinois.
authors.forename: Erica E
authors.initials: EE
authors.lastname: Kaufman
authors.affiliation: Department of Surgery, Division of Vascular Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Jacobs
mesh_terms: D000283:Administration, Intravesical; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000150:complications* / Q000175:diagnosis; D001013:Aorta, Thoracic; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D001999:Bronchoscopy; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy; D016157:Vascular Fistula / Q000150:complications* / Q000175:diagnosis
chemical_list: D001500:BCG Vaccine