Prosthetic Joint Infection due to Mycobacterium bovis after Intravesical Instillation of Bacillus Calmette-Guerin (BCG)

Table 1

Case reports of M. bovis prosthetic joint infections after intravesical BCG instillation in patients with bladder cancer.

Case report	Age/sex	Orthopedic procedure	Bladder cancer (months PTP)	BCG strain and duration of bladder cancer treatment	Clinical presentation	Cultures/drug susceptibilities	Treatment/condition
Our patient	82, male	Right THR	20	Tice BCG, 6 weeks	Right hip pain	M. bovis; sensitive to INH, RIF, ETM. Resistant to PZA	1-Stage THR, INH/RIF × 1 year. Alive and free of symptoms at 1 year
Reigstad and Siewers (2008) [10]	86, male	Left THR	10	Oncotice BCG, 9 weeks	Aseptic loosening of hardware	M. bovis; sensitive to INH, RIF, PZA	1-stage THA revision, INH, RIF, PZA × 6 months, INH/RIF × 6 months, and INH × 1 year of consolidation
Segal and Krauss (2007) [11]	76, male	Left THR	48	Multiple treatments. Strain NR	Groin pain	M. bovis; susceptibilities unknown	INH/RIF/ETM × 1 year. 2-stage arthroplasty. Alive and free of symptoms.
Guerra et al. (1998) [12]	66, male	Right THR	12	Tice BCG, 12 weeks, radical cystectomy	Hip pain, rigors and sweats	M. bovis; susceptibilities unknown	INH/RIF × 6 months and 2-stage arthroplasty. Patient died due to his underlying condition.*
Chazerain et al. (1993) [9]	77, male	Left TKR	2.5	Pasteur BCG	Acute arthritis	M. bovis; susceptibilities unknown	2 antituberculous drugs (NR) × 2 years and 2-stage arthroplasty. Alive and free of symptoms.

Abbreviations: prior to presentation (PTP), total hip replacement (THR), total knee replacement (TKR), not reported (NR), isoniazid (INH), rifampin (RIF), and ethambutol (ETM).
*Death due to lung cancer.