Mycotic arterial aneurysm secondary to BCG intravesical instillation: A review

J Med Vasc. 2022 Apr;47(2):94-105. doi: 10.1016/j.jdmv.2022.04.002. Epub 2022 May 20.

Abstract

Objective: Mycotic aortic aneurysm is a rare and life-threatening pathology. The first case of mycotic aneurysm induced by immunotherapy with bacille Calmette-Guérin for malignancy was published in 1988. The main objective of this review is to characterize this rare pathology.

Materials and methods: Since then, 60 cases of arterial aneurysm following intra vesical BCG instillation have been described in the literature. All cases have been included, and characteristics have been collected retrospectively, with simple statistical analyses of the cases.

Results: We present a brief review from 1988 to 2022 enhancing the contemporary understanding of this arterial infection. Mycotic aneurysm secondary to BCG instillation has a poor prognosis, up to 50% complication and 15% mortality at 1 month, whether managed by open repair or endovascular means.

Conclusion: BCG mycotic aneurysm is an extremely serious condition, the diagnosis of which must be considered at an early stage in order to adapt diagnostic and therapeutic strategies.

Keywords: BCG instillation; Bladder cancer; Ilio-psoas abscess; Mycobacterium bovis; Mycotic aortic aneurysm; Mycotic arterial aneurysm.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Intravesical
  • Aneurysm, Infected* / diagnostic imaging
  • Aneurysm, Infected* / etiology
  • Aneurysm, Infected* / surgery
  • Aortic Aneurysm, Abdominal* / complications
  • BCG Vaccine / adverse effects
  • Humans
  • Mycobacterium bovis*
  • Retrospective Studies
  • Urinary Bladder Neoplasms* / complications
  • Urinary Bladder Neoplasms* / drug therapy

Substances

  • BCG Vaccine