CASE REPORTS   

International Angiology 2005 March;24(1):98-101

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

Ruptured abdominal aortic aneurysm secondary to tuberculous spondylitis

Dahl T. ¹, Lange C. ¹, Ødegård A. ², Bergh K. ³, Osen S. S. ⁴, Myhre H. O. ¹

¹ Department of Surgery, St. Olavs Hospital, University Hospital of Trondheim and Institute of Circulation and Imaging Norwegian University of Science and Technology, Trondheim, Norway 2 Department of Radiology, St. Olavs Hospital, University Hospital of Trondheim and Institute of Circulation and Imaging Norwegian University of Science and Technology, Trondheim, Norway 3 Department of Microbiology, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway 4 Department of Pulmonary Diseases, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway

A 69-year-old man was admitted with low back pain and signs of nerve root compression. A computed tomography (CT) scan showed abscess formation in the left psoas region, spondylodiscitis L3-L4 and a ruptured abdominal aortic aneurysm. The aortic aneurysm was replaced with a bifurcated vascular graft. One week later, laminectomy at the L4-level was done. In a small abscess, Mycobacterium bovis was found. The condition was considered to be a mycobacterial spondylitis secondary to BCG instillations of the urinary bladder for carcinoma. The patient received antituberculous medication for 9 months. Subsequently bone transplantation and internal fixation of the spine became necessary. Three years after surgery he is in good condition and there are no signs of graft infection on CT. Spondylitis and mycotic aortic aneurysm should be kept in mind in patients who have been treated for carcinoma of the bladder with BCG instillations.