Aortic aneurysm and aortic graft infection related to Mycobacterium bovis after intravesical Bacille Calmette–Guérin therapy—a case series
M. Buerger,
S. Kapahnke,
S. Omran,
M. Schomaker,
M. Rief,
A. Greiner,
J. P. Frese
Affiliations
M. Buerger
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
S. Kapahnke
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
S. Omran
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
M. Schomaker
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
M. Rief
Institute of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
A. Greiner
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
J. P. Frese
Department of Vascular and Endovascular Surgery, Charité – Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
Abstract Background So called “mycotic” aortic aneurysms account for only 0.7 to 1.3% of all aortic aneurysms and are commonly caused by Staphylococcus aureus and Salmonella species. Bacillus Calmette-Guérin (BCG), a live attenuated strain of Mycobacterium bovis, is part of the therapy of non-muscle-invasive bladder cancer (NMIBC). Case presentation We report a case series of three patients with a mycobacterial graft infection related to BCG after surgical treatment of a presumed mycotic aortic aneurysm as an extremely rare complication after NMIBC treatment. All three patients developed aortic aneurysm after BCG instillation and subsequent mycobacterial graft infection. Conclusion Diagnosis requires a high degree of suspicion because of its nonspecific symptoms and imaging. The pathogen is not detected by standard microbiological testing. Treatment includes triple antimycobacterial therapy and radical surgical interventions. Graft preservation may be considered if no anastomosis is involved.
