Abdominal Aortic Aneurysmal and Endovascular Device Infection With Iliopsoas Abscess Caused by Mycobacterium Bovis as a Complication of Intravesical Bacillus Calmette–Guérin Therapy

Mizoguchi, Hideaki; Iida, Osamu; Dohi, Tomoharu; Tomoda, Kaname; Kimura, Hayato; Inoue, Kazushige; Iwata, Takashi; Tei, Keikou; Miura, Takuya

doi:10.1016/j.avsg.2012.12.004

Cited by 33 publications

(16 citation statements)

References 17 publications

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“…He developed 30 months after EVAR an abscess of the iliopsoas muscle fistulated with the excluded aneurysm caused by M bovis . 15 Similarly to our case, when the surgical repair was performed to place the graft, a mycotic AAA was suspected based on the CT scan results but laboratory and bacterial examinations were negative. The authors believe that the mycotic AAA with M bovis may have been latent, resulting in recurrence and graft infection months later.…”

Section: Discussionsupporting

confidence: 53%

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Mycotic Aortic Aneurysm and Infected Aortic Graft After Intravesical Bacillus Calmette-Guérin Treatment for Bladder Cancer

Lareyre

Reverso-Meinietti

Carboni³

et al. 2018

Vasc Endovascular Surg

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Although intravesical therapy with bacillus Calmette-Guérin (BCG) has proven its efficiency in the treatment of early-stage bladder cancer, infectious complications can occur and mycotic aneurysms represent a rare but life-threatening complication. Here, we report the case of an aortic graft infection in a patient with abdominal aortic aneurysm who received BCG instillations for the treatment of bladder cancer. Based on the current knowledge on this rare vascular complication, we discuss factors that may have contributed to its occurrence and review issues to optimize its management and early detection.

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Section: Discussionsupporting

confidence: 53%

“…13 Hematogenous dissemination via the vasa vasorum and lymphatic spread into the retroperitoneum are thought to be the main mechanisms causing vascular colonization. 14,15 Interestingly, atherosclerotic lesions could also favor attachment and growth of BCG. 11 The peculiarity of our case is to report an aortic graft infection related to BCG.…”

Section: Discussionmentioning

confidence: 99%

Mycotic Aortic Aneurysm and Infected Aortic Graft After Intravesical Bacillus Calmette-Guérin Treatment for Bladder Cancer

Lareyre

Reverso-Meinietti

Carboni³

et al. 2018

Vasc Endovascular Surg

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“…The patient had a tuberculous epididymitis 24 months later and anti‐TB medications were initiated. Six months after that, the excluded aneurysm formed a fistula to the iliopsoas muscle and open surgery was performed . This illustrates the difficulty of diagnosing TB aortic aneurysm and the importance of suspecting possible TB aortic aneurysm based on a history of BCG therapy.…”

Section: Resultsmentioning

confidence: 91%

“…QuantiFERON‐TB Gold, DNA‐RNA hybridization, real time polymerase chain reaction (PCR) are also useful to assist prompt diagnosis. A history of BCG therapy for bladder carcinoma, which uses a live attenuated strain of Mycobacterium bovis , should also raise concern, as this has been associated with mycotic aneurysms …”

Section: Discussionmentioning

confidence: 99%

The treatment of tuberculous aortic pseudoaneurysm

et al. 2018

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Objective: Our aim was to compare the outcomes of tuberculous aortic aneurysms treated with endovascular aortic repair (TEVAR) or open surgery. Methods: An electronic search of the National Library of Medicine PubMed database for tuberculous aortic aneurysm was performed between January 1998 through December 2017. Cases were screened for completeness of information and outcomes were recorded and analyzed. Results: A total of 56 studies were reviewed, with 61 (20 TEVAR, 41 open surgical repair) having adequate case details and follow-up. The in-hospital/30-day mortality was 0% (0 out of 20) in the TEVAR group and 7% (three out of 41) in the open surgery group (P = .54). Overall mortality was 5% (1/20) in the TEVAR group and 10% (4/41) in the open surgery group (P = .53). Two-year survival and freedom from aneurysm recurrence were comparable in the two groups, P = .45 and P = .94, respectively. One patient in the TEVAR group and one patient in the open surgery group died due to a rupture of a recurrent aortic aneurysm 16 and 28 months after surgery, respectively. Conclusions: TEVAR and anti-tuberculosis (TB) medications are reasonable initial treatment options for tuberculous aortic aneurysm especially in high-risk patients; however, careful follow-up is necessary. K E Y W O R D S endovascular repair, open surgery, tuberculous aortic pseudoaneurysm

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“…CT-guided biopsy after EVAR enables direct sampling of the periaortic wall and identification of the causative bacteria without concern about rupture. Several reports have described CT-guided drainage of abscesses of MAAs and graft infection 15, 16, 17. In these cases, drainage of the abscesses by CT-guided catheterization was performed after surgical intervention; however, the drainage was not performed to detect the causative bacteria.…”

Section: Discussionmentioning

confidence: 99%

Use of computed tomography-guided biopsy to detect Peptostreptococcus micros-induced mycotic abdominal aortic aneurysm after endovascular repair

Takigawa

Baba

Hisahara

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Mycotic aortic aneurysm (MAA) is rare but lethal. Detection of the causative bacteria is important for successful treatment. In some cases, however, no micro-organisms are detected by repeated blood cultures. Open surgery is the standard procedure for MAA, but endovascular intervention is also performed. An aneurysm specimen cannot be taken for culture when using an endovascular approach, decreasing the opportunity to detect the causative organism. We performed successful endovascular repair in a rare case of a Peptostreptococcus micros-induced MAA as detected by postoperative computed tomography-guided biopsy. This case may help to establish appropriate medical treatment for MAAs.

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Abdominal Aortic Aneurysmal and Endovascular Device Infection With Iliopsoas Abscess Caused by Mycobacterium Bovis as a Complication of Intravesical Bacillus Calmette–Guérin Therapy

Cited by 33 publications

References 17 publications

Mycotic Aortic Aneurysm and Infected Aortic Graft After Intravesical Bacillus Calmette-Guérin Treatment for Bladder Cancer

Mycotic Aortic Aneurysm and Infected Aortic Graft After Intravesical Bacillus Calmette-Guérin Treatment for Bladder Cancer

The treatment of tuberculous aortic pseudoaneurysm

Use of computed tomography-guided biopsy to detect Peptostreptococcus micros-induced mycotic abdominal aortic aneurysm after endovascular repair

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