Abstract
BackgroundProsthetic joint infections remain a significant cause of morbidity and are frustrating for patients and physicians alike. Unusual causes of infection may be seen in selected circumstances and a high index of suspicion and a careful history are required to ensure an accurate and timely diagnosis can be made.Case presentationWe present a case of Mycobacterium bovis prosthetic joint infection secondary to intravesicular Bacillus Calmette-Guérin (BCG) treatment for prior bladder cancer definitively identified by spoligotyping. A favorable clinical outcome was observed following surgical intervention and a 12-month course of anti-mycobacterial therapy.ConclusionsBCG therapy, a live attenuated strain of M. bovis, has become the mainstay of adjunctive therapy for bladder cancer and infectious complications, including those affecting the musculoskeletal system, may be seen years after initial therapy. An awareness of this complication and appropriate discussions with the institution’s microbiology laboratory may allow for an accurate and timely identification.
Highlights
Prosthetic joint infections remain a significant cause of morbidity and are frustrating for patients and physicians alike
Hip fluid, and abscess cultures obtained during irrigation and debridement were negative for bacterial pathogens, given his history of prior Bacillus Calmette-Guérin (BCG) therapy the microbiology laboratory was asked to perform mycobacterial cultures and these grew acid-fast bacilli (AFB) concerning for Mycobacterium tuberculosis complex
M. bovis is a zoonotic mycobacteria related to Mtb known to cause tuberculosis in cattle, known as bovine tuberculosis, and other animals
Summary
BCG therapy, a live attenuated strain of M. bovis, has become the mainstay of adjunctive therapy for bladder cancer and infectious complications, including those affecting the musculoskeletal system, may be seen years after initial therapy. An awareness of this complication and appropriate discussions with the institution’s microbiology laboratory may allow for an accurate and timely identification
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