Tuberculous Spondylitis Caused by Intravesical Bacillus Calmette-Guerin Therapy

Tomokazu Minakata; Yoshio Nakano; Shinobu Tamura; Yamanishi Kazuki; Kana Hayakawa; Takahiro Hayakawa; Takayuki Oota; Tokuzou Fuzimoto; Yukiko Yamano; Takemasa Takii

doi:10.2169/internalmedicine.3288-19

CASE REPORTS

Tuberculous Spondylitis Caused by Intravesical Bacillus Calmette-Guerin Therapy

Tomokazu Minakata, Yoshio Nakano, Shinobu Tamura, Yamanishi Kazuki, Kana Hayakawa, Takahiro Hayakawa, Takayuki Oota, Tokuzou Fuzimoto, Yukiko Yamano, Takemasa Takii

Author information

Tomokazu Minakata
Department of Nephrology, Kinan Hospital, Japan
Yoshio Nakano
Department of Internal Medicine, Kinan Hospital, Japan
Shinobu Tamura
Division of Hematology, Department of Internal Medicine, Wakayama Medical University, Japan
Yamanishi Kazuki
Department of Internal Medicine, Kinan Hospital, Japan
Kana Hayakawa
Department of Internal Medicine, Kinan Hospital, Japan
Takahiro Hayakawa
Department of Internal Medicine, Kinan Hospital, Japan
Takayuki Oota
Department of Internal Medicine, Kinan Hospital, Japan
Tokuzou Fuzimoto
Department of Internal Medicine, Kinan Hospital, Japan
Yukiko Yamano
Department of Nephrology, Kinan Hospital, Japan
Takemasa Takii
Department of Mycobacteriology, The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Japan

Keywords: tuberculous spondylitis, Mycobacterium bovis, bacillus Calmette-Guerin

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 5 Pages 733-737

DOI https://doi.org/10.2169/internalmedicine.3288-19

Details

Abstract

A 74-year-old man underwent intravesical bacillus Calmette-Guerin (BCG) therapy for bladder cancer and later presented with lower left back pain. Magnetic resonance imaging of the spine showed high signal intensity, diagnosed as a cystic lesion in the epidural and bilateral intestinal psoas muscle. A computed tomography-guided needle biopsy and histological examination revealed bacteria from the family Mycobacteriaceae, and Mycobacterium bovis was identified using multiplex polymerase chain reaction. If lower back pain appears in a patient who has undergone BCG therapy, it is necessary to test for tuberculous spondylitis. In addition, QuantiFERON is useful for the differential diagnosis of M. bovis BCG infection.

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