BCG
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Tuberculous epididymo-orchitis: case report A 73-year-old man developed tuberculous epididymoorchitis following treatment with BCG for bladder transitional cell carcinoma [duration of treatment to reaction onset not stated]. The man, who had a history of transurethral resection of the prostate, presented due to urinary infection and dysuria. An intravesical lesion was identified, and he underwent transurethral resection. Subsequently, he was diagnosed with grade III pT1 bladder transitional cell carcinoma. Further cystoscopy and re-resection revealed carcinoma in situ and pT1 bladder carcinoma. Hence, he was treated with adjuvant intravesicular BCG [Bacillus Calmette-Guerin] immunotherapy [dosage not stated]. He completed a 6-week course of BCG with no complications. At follow up, generalised inflammation with no recurrence was noted. He was administered a threedose maintenance course of BCG after 3 months. Subsequently, he experienced right-sided testicular swelling and pain. The man was treated with unspecified antibiotics and antiinflammatory medications. One month later, cystoscopy showed a continuation of right scrotal pain and swelling with pus ejecting from sinus in the scrotal skin. Ultrasound of the scrotum showed a heterogeneous focus of tissue calcification in the right epididymal tail and inflammatory changes related to granulomatous change. Additionally, pus swab was positive for Mycobacterium bovis. Hence, he was diagnosed with tuberculosis epididymo-orchitis. He was then treated with a 6-month course of rifampicin, isoniazid and ethambutol, and was referred to a local infectious diseases unit [outcome not stated]. Author comment: "Tuberculous-epididymitis following intravesical BCG has only been reported in a handful of cases. We describe one such case, along with radiological findings and a review of the literature for this rare complication." Rezvani S, et al. Tuberculosis epididymo-orchitis following intravesical bacillus Calmette-Guerin immunotherapy. Journal of Surgical Case Reports 2019: No. 7, Jul 2019. Available from: URL: http://doi.org/10.1093/jscr/rjz212 - United 803434125 Kingdom
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Reactions 16 Nov 2019 No. 1779
