Vertebral Osteomyelitis After Intravesical Administration of Bacille Calmette-Guerin

Civen, Rachel; Berlin, G; Panosian, Claire B.

doi:10.1093/clinids/18.6.1013

Cited by 33 publications

(23 citation statements)

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“…In these cases surgical intervention is simultaneously combined with antituberculous drugs 29 30. The duration of treatment varies between 9and 12 months 25–29 31 34 35. In our patient the spine had already stabilised because of the cement.…”

Section: Discussionmentioning

confidence: 66%

Combined infection of vertebroplasty and aortic graft after intravesical BCG treatment

Santbergen¹,

Vriens

Lange

et al. 2013

BMJ Case Reports

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We report a 58-year-old man with spondylodiscitis by Mycobacterium bovis-BCG 3 years after intravesical BCG treatment, and shortly after a vertebroplasty. Further examination showed a psoas abscess and oedema around an endovascular aortic graft, which had been placed 1 year earlier. Puncture of the psoas abscess also grew M bovis-BCG. The patient recovered with a combination of antituberculous treatment and surgery. With hindsight a mycotic aneurysm had been present at the time of aortic graft placement and spondylodiscitis at the time of vertebroplasty. This case shows that low grade and longstanding infections may occur following intravesical BCG installation.

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Section: Discussionmentioning

confidence: 66%

Combined infection of vertebroplasty and aortic graft after intravesical BCG treatment

Santbergen¹,

Vriens

Lange

et al. 2013

BMJ Case Reports

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“…In 1995 approximately 96% of all infants aged 12 to 23 months received immunization against BCG. The side effects of the BCG vaccination program include lymphadenopathy in very young infants or osteomyelitis resulting from generalized dissemination of BCG (1)(2)(3). A prior study re-ports that the frequency of lymphadenopathy among vaccinated infants is 0.73%, especially in babies under one year (4).…”

Section: Introductionmentioning

confidence: 99%

“…A prior study re-ports that the frequency of lymphadenopathy among vaccinated infants is 0.73%, especially in babies under one year (4). BCG osteomyelitis has also been reported as a complication of intravesical BCG therapy for bladder carcinoma (1). The definitive diagnosis of each case is made by the recovery of the BCG strain of Mycobacterium bovis from the affected focus.…”

Section: Introductionmentioning

confidence: 99%

BCG lymphadenopathy detected in a BCG-vaccinated infant

Barouni

Augusto²,

Queiroz

et al. 2004

Braz J Med Biol Res

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“…31 Vertebral osteomyelitis after intravesical BCG instillation for bladder cancer has only been described in 10 prior cases worldwide. 30,[32][33][34][35][36][37][38][39][40] All of the 10 cases described and our patient were men aged 66 to 94 years, with a mean age of 77 years. Diagnosis of osteomyelitis ranged from 2 weeks to 12 years after BCG bladder instillation, with most diagnoses occurring within 2 years of therapy.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium bovis Bacillus Calmette-Guérin Vertebral Osteomyelitis After Intravesical Bacillus Calmette-Guérin Used for Bladder Cancer

Vindenes¹,

McGowan²,

Woo-Roderick³

et al. 2015

Infectious Diseases in Clinical Practice

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Background: Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis and has been used for intravesical treatment of superficial bladder cancer since 1976. Systemic complications of intravesical BCG are rare, and vertebral osteomyelitis has only been described in 10 prior cases worldwide.Case: A 64-year-old white man with benign prostatic hyperplasia was diagnosed with transitional cell bladder cancer and underwent transurethral resection of bladder tumor. He received perioperative mitomycin C followed by a 6-week course of intravesical BCG. Recurrent bladder cancer was noted on follow-up cystoscopy and he was started on a second 6-week course of BCG. Before the second intravesical BCG, he developed night sweats and severe progressive back pain with bilateral lower extremity weakness. Magnetic resonance imaging of the spine revealed a T11 to T12 vertebral body destruction with discitis, and biopsy revealed M bovis BCG. He received therapy with isoniazid, rifampin, capreomycin, as well as ethambutol and, later, additional drugs (cycloserine, moxifloxacin) secondary to clinical and radiographic progression of disease. He underwent a T11 to T12 vertebrectomy and continued on isoniazid, rifampin, cycloserine, and moxifloxacin for a total of 12 months postoperatively.Conclusions: Mycobacterium bovis BCG osteomyelitis is a rare complication of intravesical BCG therapy for bladder cancer and may occur as a solitary site of infection. A high degree of suspicion is important in patients with osteomyelitis with a history of transitional cell cancer managed with immunotherapy using BCG instillations.

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Vertebral Osteomyelitis After Intravesical Administration of Bacille Calmette-Guerin

Cited by 33 publications

References 0 publications

Combined infection of vertebroplasty and aortic graft after intravesical BCG treatment

Combined infection of vertebroplasty and aortic graft after intravesical BCG treatment

BCG lymphadenopathy detected in a BCG-vaccinated infant

Mycobacterium bovis Bacillus Calmette-Guérin Vertebral Osteomyelitis After Intravesical Bacillus Calmette-Guérin Used for Bladder Cancer

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