Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Białecki, Jerzy; Nowak-Misiak, Mirosława; Rapała, Kazimierz; Marczyński, Wojciech; Suchodolski, Gracjan; Truszczyńska, Aleksandra

doi:10.1016/j.pjnns.2015.12.003

Cited by 11 publications

(3 citation statements)

References 16 publications

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“…Boruah et al (2021) [30] retrospectively evaluated the MRI imaging data of 19 patients with spinal tuberculosis and found that it was very important for the early diagnosis of patients, which was beneficial to reduce the morbidity and severity of patients. Another study retrospectively analyzed the MRI and CT imaging features of spinal tuberculosis and tumors and found that it can be used in the differential diagnosis of spinal tuberculosis and spinal tumors [31], which is consistent with the conclusions of this study. However, spinal tuberculosis and tumors have different manifestations at different stages of disease progression, and special cases may have atypical manifestations.…”

Section: Discussionsupporting

confidence: 87%

Improved Algorithm-Based Magnetic Resonance Images Combined with Computed Tomography in the Diagnosis of Acquired Immune Deficiency Syndrome Combined with Spinal Tuberculosis

Jiang

Shi

et al. 2022

Scientific Programming

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This study aimed to analyze the diagnostic value of magnetic resonance imaging (MRI) combined with computed tomography (CT) based on the improved algorithm for acquired immune deficiency syndrome (AIDS) combined with spinal tuberculosis, so as to provide an effective reference theory for the clinical application of imaging diagnosis. The ResNet and Inception network structure were combined to form an improved convolutional neural grid classification (CNGC) algorithm. The improved algorithm was applied to AIDS patients with spinal tuberculosis to evaluate its diagnostic effect and value. 50 patients with AIDS and spinal tuberculosis and 50 patients with spinal tumors were selected for MRI and CT scans. The results showed that the accuracy, specificity, and sensitivity of the improved ResNet-Inception algorithm were much higher than those of the ResNet18 and GoogLeNet algorithms. In addition, compared with the training losses of ResNet18 and GoogLeNet algorithms that converged after 700 times, the ResNet-Inception algorithm only required 350 times to achieve convergence. Based on the improved ResNet-Inception algorithm, the false positive rate (FPR) of AIDS combined with spinal tuberculosis in imaging examinations was about 4%, which was greatly lower than that of the other two traditional algorithms ( P < 0.05 ). It can be seen that the improved ResNet-Inception algorithm was more valuable than traditional algorithms for MRI combined with CT in the diagnosis of AIDS combined with spinal tuberculosis and showed great clinical value for the diagnosis of the disease and the differential diagnosis of spinal tumors.

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Section: Discussionsupporting

confidence: 87%

Improved Algorithm-Based Magnetic Resonance Images Combined with Computed Tomography in the Diagnosis of Acquired Immune Deficiency Syndrome Combined with Spinal Tuberculosis

Jiang

Shi

et al. 2022

Scientific Programming

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“…All these patients were male, with a mean age of 73.2 (35-94) years and with a median interval of 1.3 years (0.5 months-12 years) between BCG instillation and the onset of spondylitis. Chronic back pain was the most common complaint, and serious neurological symptoms might occur as a result of neurosurgical spinal cord decompression [58]. BCG spondylitis is thought to develop by hematogenous spread from the deep pelvic veins to the internal vertebral venous plexuses, which may explain its high incidence in the thoracolumbar spine [59].…”

Section: Systemic Complicationsmentioning

confidence: 99%

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Liu

Huang

et al. 2019

Journal of Oncology

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Because of its proven efficacy, intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is an important treatment for nonmuscle invasive bladder cancer at high risk of recurrence or progression. However, approximately 8% of patients have to stop BCG instillation as a result of its complications. Complications induced by BCG therapy can have a variety of clinical manifestations. These adverse reactions may occur in conjunction with BCG instillation or may not develop until months or years after BCG cessation. An essential step in the management complications arising from BCG is early establishment of diagnosis, particularly for distant, disseminated, and obscure infections. Therefore we reviewed the literature on the potential complications after intravesical BCG immunotherapy for bladder cancer and provide an overview on the incidence, diagnosis, and treatment modality of genitourinary and systemic BCG-induced complications.

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“…Other articles with M. bovis BCG infection and spinal pain have been published [34][35][36], but they were not consistent with a vertebral osteomyelitis diagnosis. The frequency is possibly underestimated knowing the possible difficulties in documenting such an infection, as in two other publications [27,37].…”

Section: Reviewmentioning

confidence: 98%

Back pain following instillations of BCG for superficial bladder cancer is not a reactive complication: review of 30 Mycobacterium bovis BCG vertebral osteomyelitis cases

et al. 2019

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Introduction: Mycobacterium bovis BCG instillations are used in bladder cancer treatment. Adverse effects can occur. Osteoarticular complications are mainly reactive arthritis, but true infections have been described, such as vertebral osteomyelitis. Methods: We made a review of M. bovis BCG vertebral osteomyelitis after instillations for bladder cancer using PubMed search. We added 3 new French cases. Review: Twenty-seven cases of BCG vertebral osteomyelitis had been reported on PubMed. Of the 30 cases, all were male, averaging 73.4 ± 8.7 year-old. Median time between diagnosis and first and last instillation was 22.5 months and 14 months respectively. Half of vertebral osteomyelitis was thoracic, and lumbar in the other half. Sensitivomotor deficit was present at diagnosis in 42% of cases. Other infectious locations were common, mainly infectious abdominal aortic aneurysms (20%). Rifampicin, ethambutol and isoniazid were the usual therapy. Poor outcomes were reported with 50% of one or more spine surgery. Conclusion: M. bovis BCG vertebral osteomyelitis following bladder instillation for bladder cancer is a rare complication. However, the late onset of back pain after instillations differentiates them from reactive arthritis. Concomitant septic location such as infectious abdominal aortic aneurysms must be known.

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Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Cited by 11 publications

References 16 publications

Improved Algorithm-Based Magnetic Resonance Images Combined with Computed Tomography in the Diagnosis of Acquired Immune Deficiency Syndrome Combined with Spinal Tuberculosis

Improved Algorithm-Based Magnetic Resonance Images Combined with Computed Tomography in the Diagnosis of Acquired Immune Deficiency Syndrome Combined with Spinal Tuberculosis

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Back pain following instillations of BCG for superficial bladder cancer is not a reactive complication: review of 30 Mycobacterium bovis BCG vertebral osteomyelitis cases

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