Mycobacterium bovis abdominal aortic and femoral artery aneurysms following intravesical bacillus Calmette–Guérin therapy for bladder cancer

Received 2 June 2008; received in revised form 4 August 2008; accepted 15 September 2008. published online 21 November 2008.

Abstract

Background

Infectious complications of intravesical bacillus Calmette–Guérin (BCG) therapy are rare, but these have included a handful of cases of mycotic aneurysm.

Methods and Results

We present the case of a patient with a ruptured abdominal aortic aneurysm and a femoral artery aneurysm who had previously received intravesical BCG therapy for bladder carcinoma. Histopathologic examination of resected tissue revealed numerous acid-fast bacilli, and subsequent mycobacterial culture of blood and resected tissue revealed BCG strain Mycobacterium bovis.

Conclusions

Clinicians should be aware of the possible extravesical complications, albeit rare, of BCG therapy. Therapy should consist of combined medical and surgical management.

Keywords: Mycotic aneurysm, mycobacteria, Mycobacterium bovis, BCG, bladder cancer

a Department of Medicine, University of Ottawa, Ottawa, ON, Canada

b Department of Surgery, University of Ottawa, Ottawa, ON, Canada

c Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada

Corresponding author. Division of Infectious Diseases, Ottawa Hospital, Civic Campus, 1053 Carling Ave., Ottawa, ON, Canada K1Y 4E9. Tel.: +1 613 761 4155; fax: +1 613 761 5260.

1 C.T. Costiniuk and A.A. Sharapov are joint first authors.

PII: S1054-8807(08)00124-5

doi:10.1016/j.carpath.2008.09.003

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