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ANTONIO CASCIO

A Case of Epididymo-orchitis after intravesical bacille Calmette-Guérin therapy for superficial bladder carcinoma in a patient with latent tuberculosis infection

  • Authors: Colomba, C.; DI CARLO, P.; Guadagnino, G.; Siracusa, L.; Trizzino, M.; Gioe', C.; Cascio, A.
  • Publication year: 2016
  • Type: Articolo in rivista (Abstract in rivista)
  • Key words: Bladder; Calmette; Complications; Guérin; Intravesical; Infectious Diseases; Oncology; Epidemiology; Cancer Research
  • OA Link: http://hdl.handle.net/10447/192939

Abstract

Background: Intravesical instillation of bacille Calmette-Guérin (BCG) has been established as efficient therapy for superficial bladder carcinoma. Overall, intravesical BCG is well tolerated and results in complications of less than 5 %. However, adverse effects such as granulomatous prostatitis, pneumonitis, hepatitis, sepsis, and hypersensitivity reactions may occur. The reported rate for tuberculous orchitis after BCG intravesical therapy is 0.4 %. Findings: We report a case of monolateral tuberculous orchitis occurring one month after the second course of intravescical instillation of bacille Calmette-Guérin in a patient with proven superficial bladder carcinoma and latent tuberculosis infection. Conclusions: In our opinion intravesical instillation of BCG should be considered on an individual patient basis, with full patient disclosure of the potentially significant risks. A screening with an intradermal Mantoux before starting the first cycle of BCG instillation should be recommended and isoniazid would be indicated as the treatment for latent tuberculosis infection.