BCGitis with aortoiliac aneurysm involvement: Report of two cases and review of the literature

Enferm Infecc Microbiol Clin (Engl Ed). 2024 Mar;42(3):152-157. doi: 10.1016/j.eimce.2023.07.003. Epub 2023 Jul 22.

Abstract

BCGitis is a rare complication after intravesical administration of Bacillus Calmette-Guérin for high-grade superficial bladder cancer and carcinoma in situ. May cause vascular involvement. We present 2 cases and a review of the literature of the case reports pubished on the 10 years prior to April of 2022, when this proyect was finished, which described a case of aortoiliac mycotic aneurysm after receiving this treatment. Of the 51 cases included (49 revised and 2 original), 100% were men, 82% were older than 65 years. The median latency period was 15 months (IQR 18). The most frequent location was the abdominal aorta, rupture occurred in 45,1% of patients. The most frequent symptom was abdominal or lumbar pain (61%), followed by general syndrome (49%). In 39,2% cases, it was associated with retroperitoneal abscesess. Attributable mortality was 13,6%. BCGitis should be included in the differential diagnosis in patients who have received BCG therapy and present vascular involvement, even years after being treated.

Keywords: Administración intravesical; Administration intravesical; Aneurisma aórtico; Aneurisma micótica; Aneurysm infected; Aortic aneurysm; BCG vaccine; Delayed diagnosis; Retraso diagnóstico; Vacuna BCG.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm, Infected* / diagnosis
  • Aneurysm, Infected* / etiology
  • Humans
  • Male
  • Mycobacterium bovis*
  • Urinary Bladder Neoplasms* / pathology
  • Urinary Bladder Neoplasms* / therapy