Mycobacterial Infection after Intravesical Bacillus Calmette-Guerin Treatment for Bladder Cancer: A Case Report.
10.3343/kjlm.2011.31.3.197
- Author:
Chang Hun PARK
1
;
Mi Ae JANG
;
Yoon Hee AHN
;
Yu Yean HWANG
;
Chang Seok KI
;
Nam Yong LEE
Author Information
1. Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mrmicro@skku.edu
- Publication Type:Case Report
- Keywords:
BCG;
Mycobacterium bovis;
Bladder cancer;
Multiplex-PCR;
Sequence analysis
- MeSH:
Administration, Intravesical;
Aged;
BCG Vaccine/administration & dosage/*adverse effects;
DNA Gyrase/genetics;
Humans;
Male;
Mycobacterium Infections/*diagnosis/etiology;
Mycobacterium bovis/genetics/*isolation & purification;
Polymerase Chain Reaction;
RNA, Ribosomal, 16S/genetics;
Urinary Bladder Neoplasms/*therapy
- From:The Korean Journal of Laboratory Medicine
2011;31(3):197-200
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bacillus Calmette-Guerin (BCG) has been traditionally used as a vaccine against tuberculosis. Further, intravesical administration of BCG has been shown to be effective in treating bladder cancer. Although BCG contains a live attenuated strain of Mycobacterium bovis, complications such as M. bovis BCG infection caused by BCG administration are extremely rare. Here, we report a case of BCG infection occurring after intravesical BCG therapy. A 67-yr-old man presented with azotemia and weight loss. He had been diagnosed with bladder cancer 4 yr back, and had undergone transurethral resection of the bladder tumor and intravesical BCG (Tice strain) therapy at that time. An acid-fast bacterial strain was isolated from his urine sample. We did not detect Mycobacterium tuberculosis protein 64 (MPT-64) antigen in the isolates obtained from his sample, and multiplex PCR and PCR-reverse blot hybridization assay indicated that the isolate was a member of the M. tuberculosis complex, but was not M. tuberculosis. Finally, sequence analysis of 16S ribosomal RNA and DNA gyrase, subunit B (gyrB) suggested that the organism was M. bovis or M. bovis BCG. Although we could not confirm that M. bovis BCG was the causative agent, the results of the 3 molecular methods and the MPT-64 antigen assay suggest this finding. This is an important finding, especially because M. bovis BCG cannot be identified using common commercial molecular genetics tools.
