Cases reported "Urinary Bladder Neoplasms"

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1/93. Refractory arthropathy after intravesical bacillus Calmette-Guerin therapy. Usefulness of isoniazide.

    BACKGROUND: arthritis associated with bacillus Calmette-Guerin immunotherapy usually responds dramatically to nonsteroidal antiinflammatory drug therapy. isoniazid is generally reserved for other complications such as granulomatous hepatitis. CASE-REPORT: A 73-year-old man was admitted for fever, arthritis of the knees and right temporomandibular joint, an inflammatory swelling over the left achilles tendon and bilateral conjunctivitis. The symptoms started in the wake of a course of intravesical bacillus Calmette-Guerin immunotherapy. Laboratory tests showed evidence of severe inflammation. Cultures of blood, urine and joint fluid specimens were negative, as were tests for autoantibodies and serologic tests for organisms known to cause reactive arthritis. Nonsteroidal antiinflammatory therapy was ineffective and glucocorticoid therapy produced only a partial response. All the symptoms resolved under isoniazid therapy in a dosage of 300 mg/day for three months. CONCLUSION: Use of antituberculous agents may be required in some cases of arthritis associated with bacillus Calmette-Guerin immunotherapy, most notably those with severe pyrexia.
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ranking = 1
keywords = bacillus
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2/93. Polyarthritis as a complication of intravesical bacillus Calmette-Guerin immunotherapy for bladder cancer.

    bacillus Calmette-Guerin (BCG) is the most effective agent currently available for the treatment of superficial bladder cancer. However, this form of treatment is associated with some complications, including arthritis. In this report, we present a 69-year-old woman who developed inflammatory polyarthritis following BCG treatment for superficial bladder cancer. The arthritis resolved following treatment with a non-steroidal anti-inflammatory drug and chloroquinine.
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ranking = 0.57142857142857
keywords = bacillus
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3/93. Diffuse alveolar damage in BCGosis: a rare complication of intravesical bacillus Calmette-Guerin therapy for transitional cell carcinoma.

    Intravesical administration of bacillus Calmette-Guerin is a relatively simple procedure used in the treatment of superficial transitional cell carcinoma of the urinary bladder. It is usually well tolerated with few major side effects. In rare instances, systemic complications can result in death. The usual autopsy finding is that of caseating and non-caseating granulomata in the affected organ. We report the second case of BCGosis in which granulomata together with acute and organising phase diffuse alveolar damage were found in the lungs.
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ranking = 0.71428571428571
keywords = bacillus
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4/93. bacillus Calmette-Guerin associated arthropathy mimicking undifferentiated spondyloarthropathy.

    The development of an inflammatory arthritis mimicking an undifferentiated spondyloarthropathy (SpA) was seen in a patient being treated for a superficial bladder cancer with intravesical bacillus Calmette-Guerin (BCG). Physical findings included classic dactylitis of both feet. This is the fourth report identifying a patient with BCG induced articular findings suggestive of a SpA with dactylitis. Studies of BCG stimulated cytokine secretion from peripheral blood mononuclear cells showed the patient to have enhanced interleukin 6 (IL-6) levels and reduced interferon-gamma (IFN-gamma) levels. Spontaneous IL-6 secretion was markedly elevated for the patient, compared to the control subject, but IFN-gamma secretion was quite similar. No differences were apparent with IL-4.
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ranking = 0.14285714285714
keywords = bacillus
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5/93. mycobacterium bovis BCG causing vertebral osteomyelitis (Pott's disease) following intravesical BCG therapy.

    We report a case of mycobacterium bovis BCG vertebral osteomyelitis in a 79-year-old man 2.5 years after intravesical BCG therapy for bladder cancer. The recovered isolate resembled M. tuberculosis biochemically, but resistance to pyrazinamide (PZA) rendered that diagnosis suspect. High-pressure liquid chromatographic studies confirmed the diagnosis of M. bovis BCG infection. The patient was originally started on a four-drug antituberculous regimen of isoniazid, rifampin, ethambutol, and PZA. When susceptibility studies were reported, the regimen was changed to isoniazid and rifampin for 12 months. Subsequently, the patient was transferred to a skilled nursing facility for 3 months, where he underwent intensive physical therapy. Although extravesical adverse reactions are rare, clinicians and clinical microbiologists need to be aware of the possibility of disseminated infection by M. bovis BCG in the appropriate setting of clinical history, physical examination, and laboratory investigation.
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ranking = 0.093940819407307
keywords = bovis
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6/93. Granulomatous hepatitis following intravesical bacillus Calmette-Guerin therapy.

    Although intravesical bacillus Calmette-Guerin (BCG) administration is an effective method in the treatment of superficial urinary bladder carcinoma, some complications may arise such as a granulomatous reaction either in the urinary tract or, in rare cases, outside the urinary tract. We report in this paper a case of granulomatous hepatitis following intravesical BCG administration.
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ranking = 0.71428571428571
keywords = bacillus
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7/93. endophthalmitis from mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for bladder carcinoma.

    PURPOSE: To present clinical and histologic findings of intraocular infection with mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for treatment of bladder carcinoma. methods: A 77-year-old man was initially seen with visual acuity of 20/200, focal retinitis, vasculitis, and progressive vitreous opacity in the right eye and visual acuity of light perception, intraocular inflammation, and a dense cataract in the left eye 14 months after intravesicular injection of live bacille Calmette-Guerin organisms. RESULTS: Vitreous cultures in the right eye demonstrated growth of bacille Calmette-Guerin organisms. Bilateral loss of light perception occurred despite systemic antimy-cobacterial therapy. Histopathologic examination demonstrated nongranulomatous inflammation and acid-fast bacilli in both eyes. CONCLUSION: Delayed endogenous endophthalmitis may develop after intravesicular bacille Calmette-Guerin injection that may not respond to systemic agents. Intravitreal therapy may be indicated.
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ranking = 0.067100585290934
keywords = bovis
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8/93. Epididymo-orchitis following intravesical bacillus Calmette-Guerin therapy.

    OBJECTIVE: To describe a case of epididymo-orchitis that developed four years after treatment with intravesical bacillus Calmette-Guerin (BCG) and to review the incidence of this adverse effect. DATA SOURCES: Information about the patient was obtained from the medical chart. A medline search of English-language literature (from January 1976 to April 1999) was conducted. STUDY SELECTION: All case reports of BCG-related epididymo-orchitis were evaluated. review articles describing complications of BCG therapy for bladder cancer and the prevention and treatment of these complications were reviewed. DATA EXTRACTION: Studies were evaluated for reports of BCG-related epididymo-orchitis and its treatment. DATA SYNTHESIS: Our case report is compared with others reported in the literature. The incidence of BCG-associated epididymoorchitis is rare. CONCLUSIONS: Epididymo-orchitis should be considered as a late complication of BCG therapy for bladder cancer. Proper patient selection may help decrease the risk of complications from BCG therapy.
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ranking = 0.71428571428571
keywords = bacillus
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9/93. hepatitis in disseminated bacillus Calmette-Guerin infection.

    Local immunotherapy with an attenuated live strain of mycobacterium bovis, bacillus Calmette-Guerin (BCG), is an effective and frequently used treatment for in situ transitional cell carcinoma (TCC) of the bladder. Success rates are high, and serious side effects are infrequent but can affect every organ system. A 79-year-old patient with recently diagnosed TCC who was treated with intravesical BCG for a recurrence after initial surgical treatment is reported. After unsuccessful attempts at bladder catheterization with the creation of a false passage for his third treatment, BCG was instilled via a suprapubic catheter the same day and again a week later. Two weeks after the third BCG instillation, the patient presented with profound lethargy and weakness to the point of not being able to get up out of a chair. He was febrile, anorexic, icteric and had hepatosplenomegaly. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. Empirical treatment was started with antituberculous combination therapy. A short course of an oral corticosteroid was given. Clinical improvement was marked and sustained so that the patient could be discharged home for the full six-month course of his treatment. Disseminated BCG infection with granulomatous hepatitis can be severe and life-threatening in cases where a large intravascular inoculum of BCG may have been given inadvertently.
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ranking = 0.7277058313439
keywords = bacillus, bovis
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10/93. Nephrogenic adenoma of the bladder after intravesical bacillus Calmette-Guerin treatment.

    A 60-year-old female patient was subjected to transurethral resection of transitional cell carcinoma of the bladder and was given intravesical bacillus Calmette-Guerin treatment for 6 weeks. The control cytoscopy performed after 6 months revealed a polypoid lesion at the trigon and the lesion was resected. The pathological examination of the specimen showed no evidence of cancer but the presence of a metaplastic lesion that was nephrogenic adenoma.
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ranking = 0.71428571428571
keywords = bacillus
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