Tuberculous epididymitis following intravesical Bacillus Calmette-Guérin immunotherapy.
Intravesical Bacillus Calmette-Guérin (BCG) is widely used as an adjuvant therapy in the treatment of superficial bladder cancer. BCG is administered as a live, attenuated form of Mycobacterium bovis, and acts as an immunomodulary agent to delay tumor progression. BCG is generally well tolerated, though localized and systemic infectious complications may occur. A literature search revealed that tuberculous epididymitis is a rarely reported complication of intravesical BCG therapy. We report the case of an 82-year-old male who developed tuberculous epididymitis while undergoing intravesical BCG treatment for transitional cell carcinoma of the bladder. Right orchiectomy was performed, followed by rifampin and isoniazid therapy once M. bovis was identified as the infectious agent. The patient responded well to these treatments, and made a full recovery. Tuberculous epididymitis is an uncommon complication resulting from intravesical BCG therapy, which is likely explained by retrograde migration from the prostatic urethra in this case.
Department of Urologic Sciences, University of British Columbia (Island Medical Program), Victoria, BC, Canada.
Nathan
N
Hoag
Peter J
PJ
Pommerville
Pamela C
PC
Kibsey
Douglas J
DJ
Cavers
Richard J
RJ
Eddy
D000283:Administration, Intravesical; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D004823:Epididymitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D006099:Granuloma / Q000473:pathology; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects; D008297:Male; D009919:Orchiectomy; D014389:Tuberculosis, Male Genital / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D018608:Ultrasonography, Doppler; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D001500:BCG Vaccine