Open AccessFluorescence in situ hybridization microscopic detection of Bacilli Calmette Guérin mycobacteria in aortic lesions
Author(s) -
Florent Darriet,
Paola Bernioles,
Ahmed Loukil,
Nadia Saïdani,
Carole Eldin,
Michel Drancourt
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000011321
Subject(s) - medicine , tuberculosis , pathology , mycobacterium tuberculosis , rpob , fluorescence in situ hybridization , mycobacterium tuberculosis complex , isoniazid , mycobacterium , mycobacterium bovis , rifampicin , gene , biology , biochemistry , chromosome
Rationale: To improve the diagnosis of life-threatening Bacilli Calmette Guérin (BCG) arterial aneurysm in patients treated by intravesical instillation of BCG vaccine as adjunctive therapy for non-muscular bladder carcinoma, is a life-threatening condition. Its diagnosis remains cumbersome. Patient concerns: One patient with a history of intravesical BCG installation presented with aortic aneurysm with routine microscopic examination after Ziehl-Neelsen staining remaining negative. Diagnoses: We used fluorescence in situ hybridization (FISH) to target the Mycobacterium tuberculosis complex rpob gene in a fresh aortic specimen. FISH yielded fluorescent mycobacteria in aortic lesions; mycobacteria were further confirmed as Mycobacterium bovis BCG mycobacteria by polymerase chain reaction (PCR) sequencing. Interventions: The patient benefited from an antituberculous treatment combining rifampicin, isoniazid, and ethambunol. Outcome: A 9-month follow-up indicated a favorable outcome. Lessons: This case report teaches that FISH targeting the M tuberculosis complex rpo B gene should be incorporated in the laboratory investigation of aortic aneurysm in patients with a history of bladder carcinoma.