Mycobacterial Osteomyelitis of the Spine Following Intravesical BCG Therapy for Bladder Cancer.

July 1, 2017 at 4:28 pm

Cureus. 2016 Mar 26;8(3):e545.                                                 

Mackel CE1, Burke SM1, Huhta T1, Riesenburger R1, Weller SJ1.

Author information

1 Department of Neurosurgery, Tufts University School of Medicine/Tufts Medical Center.

Abstract

Osteomyelitis is an infection of the bone that can involve the vertebral column.

A rare cause of vertebral osteomyelitis is Mycobacterium bovis after intravesical Bacillus Calmette-Guerin (BCG) therapy for transitional cell carcinoma of the bladder.

In this report, we describe the case of a 64-year-old male presenting with constitutional symptoms, progressive thoracic kyphosis, and intractable T11 and T12 radiculopathies over the proceeding six months. A CT scan revealed erosive, lytic changes of the T12 and L1 vertebrae with compression of the T12 vertebra.

An MRI demonstrated T11-12 osteomyelitis with intervening discitis and extensive paraspinal enhancement with a corresponding hyperintensity on a short tau inversion recovery (STIR) sequence.

A needle aspiration grew out Mycobacterial tuberculosis complex that was pansensitive to all antimicrobial agent therapies, except pyrazinamide on culture, a finding consistent with an M. bovis infection.

The patient’s infection and neurologic compromise resolved after transthoracic T11-12 vertebrectomies with decompression of the spinal cord and nerve roots as well as T10-L1 instrumented fusion and protracted antimicrobial therapy.

The epidemiology and natural history of M. bovis osteomyelitis are reviewed and the authors emphasize a mechanism of vertebral inoculation to explain the predilection of M. bovis osteomyelitis in males after intravesical BCG therapy

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846392/pdf/cureus-0008-000000000545.pdf

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Entry filed under: Biología Molecular, Epidemiología, Infecciones osteo-articulares-musculares, Metodos diagnosticos, Micobacterias, REPORTS, Sepsis, Update.

Mycobacterium bovis Osteomyelitis of the Thoracic Spine Mimicking a Metastatic Lytic Lesion in a Patient Exposed to Intravesicular Bacille Calmette-Guérin Treatment. Pharmacokinetics of ertapenem following intravenous and subcutaneous infusions in patients.


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