Tuberculous Spondylitis Caused by Intravesical Bacillus Calmette-Guerin Therapy

Minakata, Tomokazu; Nakano, Yoshio; Tamura, Shinobu; Yamanishi, Kazuki; Hayakawa, Kazunobu; Hayakawa, Takahiro; Oota, Takayuki; Fuzimoto, Tokuzou; Yamano, Yukiko; Takii, Takemasa

doi:10.2169/internalmedicine.3288-19

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…To the best of our knowledge, including our case, only 27 cases of tuberculous spondylitis caused by BCG treatment for bladder cancer have been reported to date, and surgery has been performed in 18 of them 6 7. Across the existing reports of tuberculous spondylitis after intravesical BCG therapy for bladder cancer, a posterior or combined operative approach was used 6.…”

Section: Discussionmentioning

confidence: 92%

“…T-SPOT is usually negative for M. bovis ; therefore, PCR by tissue sampling is required for the definitive diagnosis of BCG-related spondylitis. Additionally, PCR is necessary to investigate drug sensitivity and provide appropriate treatment 7 13 14. Our patient was initially administered four drugs, but pyrazinamide was discontinued when M. bovis, which is resistant to this drug, was identified.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, the species that can affect humans include M. tuberculosis, Mycobacterium bovis, Mycobacterium microti and Mycobacterium africanum 4. Although several spinal tuberculosis cases have been reported to date,5 cases of tuberculosis after the treatment of bladder cancer with intravesical BCG, a live attenuated vaccine derived from M. bovis , are very rare 6 7. Here, we report the case of a patient with tuberculous spondylitis caused by BCG treatment for bladder cancer and present the clinical findings of this rare case in detail, along with a summary of the relevant literature.…”

Section: Introductionmentioning

confidence: 95%

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Tuberculous spondylitis following intravesical Bacillus Calmette-Guérin therapy for bladder cancer surgically treated through the anterior approach

et al. 2022

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Intravesical BCG therapy is commonly used to treat superficial bladder cancer. Although various complications associated with this therapy have been reported, tuberculous spondylitis is uncommon. Here, we report a rare case of tuberculous spondylitis that occurred after intravesical BCG therapy for bladder cancer. A man in his 80s received BCG immunotherapy for bladder cancer and developed low back pain after treatment. Remarkably, he presented with neurological symptoms. Spondylitis was suspected on imaging. CT-guided biopsy was performed to confirm the diagnosis. Consequently,Mycobacterium boviswas identified as the causative pathogen by multiplex PCR. Multidrug therapy, administered for several months, was ineffective. Therefore, surgery was performed through an anterior approach. The symptoms, including low back pain, improved and postoperative C reactive protein tests were within the normal range. Tuberculous spondylitis following BCG therapy should be considered in cases with a history of bladder cancer treatment.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Tuberculous spondylitis following intravesical Bacillus Calmette-Guérin therapy for bladder cancer surgically treated through the anterior approach

et al. 2022

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“…BCG is a live attenuated strain of Mycobacterium bovis , used for vaccination, and as immunotherapy for non–muscle-invasive urinary bladder cancer after TURBT 1 . BCG vaccine may cause disseminated BCG infection in the form of systemic infection including miliary tuberculosis, lymphadenitis, or involvement of other extravesical tissues such as prostate, epididymis/testes, kidneys, and liver 2,3 . Vertebral infections are rarely seen in the form of BCG osteitis 4 .…”

mentioning

confidence: 99%

“…1 BCG vaccine may cause disseminated BCG infection in the form of systemic infection including miliary tuberculosis, lymphadenitis, or involvement of other extravesical tissues such as prostate, epididymis/testes, kidneys, and liver. 2,3 Vertebral infections are rarely seen in the form of BCG osteitis. 4 To our knowledge, there are very few reported cases of tuberculous spondylitis or osteitis presenting as a complication of intravesical BCG administration.…”

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confidence: 99%

Tubercular Spondylitis

et al. 2022

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BCGosis is a rare complication of intravesical BCG immunotherapy as adjuvant therapy for urinary bladder cancer manifesting in the form of disseminated tuberculosis or organ-specific tuberculosis, rarely involving the vertebra. PSMA is overexpressed in prostate cancer but also expressed in a variety of benign and malignant conditions. We present a patient with incidental detection of abnormal uptake in a vertebral lesion during assessment of prostate cancer with 18 F-PSMA PET/CT, subsequently proven to be vertebral osteitis, likely due to BCG immunotherapy. The case highlights the role of interdisciplinary patient assessment to confirm nature of abnormal foci on 18 F-PSMA PET/CT.

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Human microbiomes in cancer development and therapy

Xia

Liu

et al. 2023

MedComm

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Colonies formed by bacteria, archaea, fungi, and viral groups and their genomes, metabolites, and expressed proteins constitute complex human microbiomes. An increasing evidences showed that carcinogenesis and disease progression were link to microbiomes. Different organ sources, their microbial species, and their metabolites are different; the mechanisms of carcinogenic or procancerous are also different. Here, we summarize how microbiomes contribute to carcinogenesis and disease progression in cancers of the skin, mouth, esophagus, lung, gastrointestinal, genital, blood, and lymph malignancy. We also insight into the molecular mechanisms of triggering, promoting, or inhibiting carcinogenesis and disease progress induced by microbiomes or/and their secretions of bioactive metabolites. And then, the strategies of application of microorganisms in cancer treatment were discussed in detail. However, the mechanisms by which human microbiomes function are still poorly understood. The bidirectional interactions between microbiotas and endocrine systems need to be clarified. Probiotics and prebiotics are believed to benefit human health via a variety of mechanisms, in particular, in tumor inhibition. It is largely unknown how microbial agents cause cancer or how cancer progresses. We expect this review may open new perspectives on possible therapeutic approaches of patients with cancer.

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Tuberculous Spondylitis Caused by Intravesical Bacillus Calmette-Guerin Therapy

Cited by 6 publications

References 19 publications

Tuberculous spondylitis following intravesical Bacillus Calmette-Guérin therapy for bladder cancer surgically treated through the anterior approach

Tuberculous spondylitis following intravesical Bacillus Calmette-Guérin therapy for bladder cancer surgically treated through the anterior approach

Tubercular Spondylitis

Human microbiomes in cancer development and therapy

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