Infect Chemother.  2015 Dec;47(4):256-260. 10.3947/ic.2015.47.4.256.

Infected Aortic Aneurysm caused by Mycobacterium bovis after Intravesical Bacillus Calmette-Guerin Treatment for Bladder Cancer

• Nam EY
• Na SH
• Kim SY
• Yoon D
• Kim CJ
• Park KU
• Min SK
• Lee SE
• Choe PG

• KMID: 2170504
• DOI: http://doi.org/10.3947/ic.2015.47.4.256

Abstract

A 70-year-old man presented with lower back pain and cyanotic changes in his left lower extremity. He was diagnosed with infected aortic aneurysm and infectious spondylitis. He had received intravesical Bacillus Calmette-Guerin (BCG) therapy up to 1 month before the onset of symptoms. The aneurysm was excised and an aorto-biiliac interposition graft was performed. Mycobacterium tuberculosis complex was cultured in the surgical specimens. Real-time polymerase chain reaction (PCR) targeting the senX3-regX3 region, and multiplex PCR using dual-priming oligonucleotide primers targeting the RD1 gene, revealed that the organism isolated was Mycobacterium bovis BCG. The patient took anti-tuberculosis medication for 1 year, and there was no evidence of recurrence at 18 months follow-up.

Keyword

Mycobacterium bovis; Aneurysm, Infected; Spondylitis; Administration, intravesical

MeSH Terms

Administration, Intravesical
Aged
Aneurysm
Aneurysm, Infected
Aortic Aneurysm*
Bacillus*
DNA Primers
Follow-Up Studies
Genes, rev
Humans
Low Back Pain
Lower Extremity
Multiplex Polymerase Chain Reaction
Mycobacterium bovis*
Mycobacterium tuberculosis
Mycobacterium*
Real-Time Polymerase Chain Reaction
Recurrence
Spondylitis
Transplants
Urinary Bladder Neoplasms*
Urinary Bladder*
DNA Primers

Figure

• 

  Figure 1 Contrast-enhanced computed tomography of the abdomen and lower extremity revealed inflammatory soft tissue infiltration in the prevertebral space and left psoas muscle, with probable abscess formation (A, C, round), focal pseudoaneurysm (B, arrow), and occlusion of the left posterior artery (D, arrow).

• 

  Figure 2 Magnetic resonance imaging of the lumbar spine revealed anterior paravertebral phlegmonous and abscess-like soft tissue lesions at L4 (arrow).

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