Mycotic Abdominal Aortic Aneurysm after Adjuvant Therapy with Bacillus Calmette-Guérin in Patients with Urothelial Bladder Cancer: A Rare but Misinterpreted Complication

Bacillus Calmette-Guerin (BCG) therapy is often associated with side effects. The most feared is disseminated sepsis that may occur rarely with the development of mycotic aortic aneurysms. Twenty cases of patients treated with intravesical BCG complicated by mycotic abdominal aortic aneurysm have been reported in the literature, including 2 cases of the present study. Delayed vascular work-up represents a critical aspect. Mycotic aneurysms evidence a rapid progression. Primary care physicians and urologists should be sensitized to recognize unspecified symptoms such as potential clinical manifestations of a mycotic abdominal aortic aneurysm, even several months or years after BCG therapy.