Tuberculous epididymo-orchitis following intravesical BCG for superficial bladder cancer.
A seventy-two-year-old man with transitional cell carcinoma of the bladder received intravesical Bacillus Calmette-Guérin (BCG) following which he developed left testicular pain and swelling that partially resolved with conservative treatment. Six months later a second course of BCG was given for recurrent disease. Ten months later, he developed left testicular swelling and severe induration along with a draining scrotal sinus. Tuberculous orchitis was suspected and a left orchiectomy was performed. Pathology showed caseating granulomatous orchitis and epididymitis with numerous acid fast bacilli on Ziehl-Neelson stain. The patient received a six-month course of antituberculous therapy. This case highlights a rare but serious complication of intravesical BCG.
Bulbul
Muhammad A
MA
Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon. mb30@aub.edu.lb
Hijaz
Adonis
A
Beaini
Mona
M
Araj
George F
GF
Tawil
Ayman
A
D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D004823:Epididymitis / Q000209:etiology*; D006801:Humans; D008297:Male; D009920:Orchitis / Q000209:etiology*; D014389:Tuberculosis, Male Genital / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D001500:BCG Vaccine