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Disseminated Mycotic Aneurysms following Intravesical Bacillus Calmette-Guérin Therapy for Bladder Cancer: Case Discussion and Systematic Treatment Algorithm. Ann Vasc Surg 2017 Feb;39:284.e5-284.e10

Date

08/18/2016

Pubmed ID

27531091

DOI

10.1016/j.avsg.2016.05.120

Scopus ID

2-s2.0-84994504590   2 Citations

Abstract

Numerous case reports have highlighted the relationship between bacillus Calmette-Guérin (BCG) therapy and development of systemic mycotic aneurysms but none have established a management algorithm in patients with suspected vascular dissemination of Mycobacterium bovis. Delay in diagnosis of this disease process will lead to delays in initiation of antimycobacterium treatment to prevent dissemination into other arterial beds and potentially complicate effective surgical treatment leading to aneurysmal rupture and other devastating vascular consequences. Given the increasing number of reported cases in the literature and the ongoing, standard of care utilization of BCG for bladder cancer, we believe that a systematic approach to the management of patients with suspected BCG-related mycotic aneurysms should be set in place to prevent misdiagnosis and delays in treatment. In this report, we discuss the presentation, work-up, and report our treatment algorithm of a patient who developed diffuse peripheral mycotic aneurysms following BCG therapy for bladder cancer.

Author List

Lee CJ, Davila D, Dua A, Keyashian B, Dux J, Seabrook GR, Brown K, Malinowski M, Hieb RA, Lewis B

Authors

Robert A. Hieb MD Professor in the Radiology department at Medical College of Wisconsin
Brian D. Lewis MD Professor in the Surgery department at Medical College of Wisconsin
Michael Malinowski MD Associate Professor in the Surgery department at Medical College of Wisconsin
Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Administration, Intravesical
Algorithms
Aneurysm, Infected
Antineoplastic Agents
Antitubercular Agents
BCG Vaccine
Blood Vessel Prosthesis Implantation
Computed Tomography Angiography
Critical Pathways
Endovascular Procedures
Humans
Male
Middle Aged
Mycobacterium bovis
Predictive Value of Tests
Treatment Outcome
Tuberculosis, Cardiovascular
Urinary Bladder Neoplasms
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc