The double-edged sword - prosthetic joint infection following BCG treatment for bladder cancer: a case report

Prosthetic joint infections remain a significant cause of morbidity and are frustrating for patients and physicians alike. Unusual causes of infection may be seen in selected circumstances and a high index of suspicion and a careful history are required to ensure an accurate and timely diagnosis can...

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Bibliographic Details
Published in:BMC infectious diseases 2019-04, Vol.19 (1), p.331-4, Article 331
Main Authors: Nguyen, Minh-Vu Hoang, Giordani, Mauro M, Thompson, 3rd, George R
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Arthritis, Infectious - diagnosis
Arthritis, Infectious - drug therapy
Arthritis, Infectious - etiology
Bacillus Calmette-Guerin vaccine
BCG
BCG Vaccine - adverse effects
BCG Vaccine - therapeutic use
Beef cattle
Bladder
Bladder cancer
Cancer
Care and treatment
Case Report
Case reports
Cattle
Complications
Diagnosis
Drug therapy
Hip - diagnostic imaging
Humans
Infection
Infections
Infectious diseases
Joint diseases
Joint surgery
Joints (anatomy)
Male
Medical personnel
Metronidazole
Microbiology
Morbidity
Musculoskeletal system
Mycobacterium bovis
Mycobacterium bovis - physiology
Physicians
Prostheses
Prostheses and implants
Prosthetic joint infection
Spoligotyping
Surgery
Therapy
Tuberculosis
Urinary Bladder Neoplasms - therapy
Vaccines
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Summary:Prosthetic joint infections remain a significant cause of morbidity and are frustrating for patients and physicians alike. Unusual causes of infection may be seen in selected circumstances and a high index of suspicion and a careful history are required to ensure an accurate and timely diagnosis can be made. We present a case of Mycobacterium bovis prosthetic joint infection secondary to intravesicular Bacillus Calmette-Guérin (BCG) treatment for prior bladder cancer definitively identified by spoligotyping. A favorable clinical outcome was observed following surgical intervention and a 12-month course of anti-mycobacterial therapy. BCG therapy, a live attenuated strain of M. bovis, has become the mainstay of adjunctive therapy for bladder cancer and infectious complications, including those affecting the musculoskeletal system, may be seen years after initial therapy. An awareness of this complication and appropriate discussions with the institution's microbiology laboratory may allow for an accurate and timely identification.
ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-019-3951-1