Mycobacterium bovis discitis as a complication of intravesical Bacillus Calmette-Guérin therapy.
We report a culture-proven case of Mycobacterium bovis discitis in a 67-year-old man who had received intravesical Bacillus Calmette-Guérin for bladder cancer 5 years previously. He presented with severe low back pain, and imaging revealed features of discitis and paraspinal abscesses. On aspiration of the abnormal tissue, culture confirmed infection with M. bovis. Quadruple antituberculous therapy was commenced at this stage, with a subsequent good clinical response. Hematogenous spread of M. bovis is a rare, often delayed, complication of intravesical BCG therapy, but early appropriate treatment can result in a good prognosis.
Department of Rheumatology, Christchurch Hospital, Christchurch, United Kingdom. a_colebatch@hotmail.com
Alexandra N
AN
Colebatch
Karen E
KE
Mounce
D000283:Administration, Intravesical; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D015299:Discitis / Q000382:microbiology*; D004359:Drug Therapy, Combination; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D000995:Antitubercular Agents; D001500:BCG Vaccine