Mycobacterium bovis BCG spinal osteomyelitis in a affected person with bladder most cancers with out a historical past of BCG instillation.
BMJ Case Rep. 2018 Jul 30;2018:
Authors: Gupte A, Matcha A, Lauzardo M
BCG has been used as intravesical immunotherapy for the remedy of bladder carcinoma. Nevertheless, this remedy just isn’t innocent and will result in problems, with a reported incidence of systemic BCG an infection starting from three% to 7%. We report a case of culture-proven Mycobacterium bovis (BCG) vertebral osteomyelitis in a 72-year-old affected person with bladder carcinoma who was handled with intravesical mitomycin C however didn’t obtain BCG. Cultures from biopsy recovered isolate resembling Mycobacterium tuberculosis biochemically, however immune to pyrazinamide (PZA). The affected person was initially began on a four-drug antituberculous routine of isoniazid, rifampin, ethambutol and PZA. After genotypic evaluation recognized the organism as M. bovis (BCG), the routine was modified to isoniazid and rifampin for 12 months. The affected person responded effectively to this remedy. This case is exclusive because the affected person acquired solely intravesical mitomycin and didn’t obtain BCG, implying the potential of transmission from contaminated gear.
PMID: 30065051 [PubMed – in process]