Mycobacterium bovis-induced Aneurysm after Intravesical Bacillus Calmette-Guérin Therapy: A Case Study and Literature Review

Intern Med. 2018 Feb 1;57(3):429-435. doi: 10.2169/internalmedicine.9102-17. Epub 2017 Nov 1.

Abstract

Mycobacterium bovis infection after intravesical Bacillus Calmette-Guérin (BCG) therapy is rare. A 65-year-old Japanese man with history of bladder cancer and intravesical BCG therapy, presented with low-grade fever. An aneurysm with perianeurysmal fluid was suspected and endovascular aortic repair was performed. After 160 days, he developed blood-streaked sputum and computed tomography images revealed that the perianeurysmal fluid area was increasing in size. A multiplex polymerase chain reaction using sputum identified M. bovis. Treatment with anti-tuberculosis drugs reduced the size of the perianeurysmal fluid area. After intravesical BCG therapy, the possibility of M. bovis infection should be considered, thus further investigations are required.

Keywords: Bacillus Calmette-Guérin therapy; Mycobacterium bovis; aortic aneurysm; multiplex polymerase chain reaction.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Intravesical
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Aortic Aneurysm, Abdominal / etiology*
  • Aortic Aneurysm, Abdominal / microbiology
  • Aortic Aneurysm, Abdominal / surgery*
  • Asian People
  • BCG Vaccine / therapeutic use*
  • Humans
  • Male
  • Mycobacterium Infections / drug therapy*
  • Mycobacterium Infections / etiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tretoquinol
  • Tuberculosis, Cardiovascular / diagnosis
  • Tuberculosis, Cardiovascular / drug therapy*
  • Tuberculosis, Cardiovascular / microbiology
  • Tuberculosis, Cardiovascular / surgery
  • Vascular Surgical Procedures / adverse effects*

Substances

  • Anti-Bacterial Agents
  • BCG Vaccine
  • Tretoquinol