Successful endovascular treatment of abdominal aortic rupture secondary to bacillus Calmette-Guérin vaccine

Bacillus Calmette-Guérin (BCG) vaccine has been successfully used to treat bladder cancer. However, sporadic cases of mycotic arterial aneurysms have been reported. These patients typically develop a Mycobacterium bovis infection of an existing aneurysm or graft. In the present report, we have described the case of a patient with a ruptured nonaneurysmal abdominal aorta years after intravesicular BCG therapy. Emergent aortic endograft repair was successful. After subsequent evaluation confirmed M. bovis infection, the patient was treated with a prolonged course of antimycobacterial therapy. Vascular surgeons should maintain suspicion for atypical aortic ruptures in patients with exposure to intravesicular BCG therapy.