Tuberculosis of the Penis After Intravesical Bacillus Calmette-Guerin Treatment

Latini, Jerilyn M.; WANG, DAVID S.; Bihrle, William

doi:10.1097/00005392-200006000-00061

Cited by 6 publications

(7 citation statements)

References 3 publications

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“…Of all these cases, one case demonstrated the growth of M. tuberculosis, [2] while two cases demonstrated the [4,6] In our patient, the tissue culture grew M. tuberculosis, so we conclude that he had primary tuberculosis of glans penis after intravesical instillation of BCG, as described before by Yoshida et al [10] The plausible explanation for this could be that either traumatic BCG inoculation predisposes to tubercular infection or BCG undergoes some mutational changes to acquire M. tuberculosis like characteristics. The PCR for M. tuberculosis was negative and it was found to be of low specificity and sensitivity in cutaneous tuberculosis in another study carried out at our institute.…”

Section: Discussionmentioning

confidence: 99%

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Primary tuberculosis of glans penis after intravesical bacillus calmette guerin immunotherapy

Sharma¹,

Sethy²,

Dogra³

et al. 2011

Indian J Dermatol Venereol Leprol

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A 55-year-old male with carcinoma in situ of urinary bladder was treated with weekly intravesical injections of Bacillus Calmette Guerin (BCG) vaccine. Three days after the sixth injection, he developed low grade fever and multiple grouped punched out, 2-3 mm ulcers around meatus and corona glandis. In addition, multiple, firm, indurated, nontender papules and few deeper nodules were present on the proximal part of glans penis, along with bilateral enlarged, matted and nontender inguinal lymph nodes. There was no history suggestive of sexually transmitted diseases and high risk behavior. Chest X-ray was within normal limits, and Mantoux, Venereal Disease Research Laboratory (VDRL) and HIV antibody tests were negative. The biopsy from the penile ulcer revealed epithelioid cell granuloma with Langhans giant cells. Fine needle aspiration cytology from the lymph node also revealed epithelioid cell granuloma and acid fast bacilli on Ziehl Neelsen's stain. The tissue biopsy grew Mycobacterium tuberculosis. The BCG immunotherapy was stopped and patient was treated with four drug antitubercular therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide in standard daily doses along with pyridoxine. The edema resolved and the ulcers started healing within 2 weeks, and at 6 weeks after starting antitubercular therapy almost complete healing occurred. To the best of our knowledge, we describe the first case of an Indian patient with BCG induced primary tuberculosis of penis after immunotherapy for carcinoma urinary bladder and review the previously described cases to increase awareness of this condition in dermatologists and venereologists.

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Section: Discussionmentioning

confidence: 99%

“…[1] Primary infection of glans penis is an extremely rare complication of this therapy and we report here one such case. [2][3][4][5][6][7][8][9][10][11][12][13] …”

mentioning

confidence: 99%

Primary tuberculosis of glans penis after intravesical bacillus calmette guerin immunotherapy

Sharma¹,

Sethy²,

Dogra³

et al. 2011

Indian J Dermatol Venereol Leprol

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“…Infectious complications from intravesicular instillation of BCG are rare, but awareness and recognition of potential complications are important. After identification of AFB and treatment with isoniazid and ethambutol, the penile lesions resolved [45]. Although clinical manifestations of infectious complications of BCG are infrequent, surgical cystoprostatectomy specimens from 12 patients treated previously with BCG revealed granulomatous prostatitis in nine of 12 (75%), and AFB were identified in seven of 12 (58%) [44].…”

Section: Tuberculous Complications Of Intravesicular Bacillus Calmettmentioning

confidence: 99%

An update on lower urinary tract tuberculosis

Wise

Shteynshlyuger²

2007

Current prostate reports

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Tuberculosis of the genitourinary tract presents with atypical manifestations. Only 20% to 30% of patients with genitourinary tuberculosis have a history of pulmonary infection. Tuberculosis often affects the lower genitourinary system rather than the kidney. Tuberculosis of the lower genitourinary tract most commonly affects the epididymis and the testis, followed by bladder, ureter, prostate, and penis. Use of bacillus Calmette-Guérin therapy for bladder cancer can cause symptomatic tubercular infections of the lower genitourinary tract. Tuberculosis of the lower genitourinary tract can present with irritative voiding symptoms, hematuria, epididymo-orchitis, prostatitis, and fistulas. Tuberculosis of the seminal vesicles, vas, fallopian tubes, and the uterus can cause infertility. Urinalysis may demonstrate sterile pyuria, hematuria, or albuminuria. Identification of acid-fast bacilli in culture or tissue or by polymerase chain reaction studies is diagnostic. Medical treatment may not result in resolution of symptoms. Surgical intervention and reconstruction of the urinary tract are frequently indicated.

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“…21 Tuberculous infection of the epididymis may be clinically detectable as early as 2 weeks after intravesical BCG instillation, 22 or as late as 3 years afterwards. 24,25 Although the complication rates seem to be low, awareness of the possibility of TB infection, even months or years after BCG has been given, is important. 24,25 Although the complication rates seem to be low, awareness of the possibility of TB infection, even months or years after BCG has been given, is important.…”

Section: Intravesical Bcg Administration and Genital Tuberculosismentioning

confidence: 99%

Male genital tuberculosis

Çek¹

2009

Tuberculosis

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Tuberculosis of the Penis After Intravesical Bacillus Calmette-Guerin Treatment

Cited by 6 publications

References 3 publications

Primary tuberculosis of glans penis after intravesical bacillus calmette guerin immunotherapy

Primary tuberculosis of glans penis after intravesical bacillus calmette guerin immunotherapy

An update on lower urinary tract tuberculosis

Male genital tuberculosis

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