View source for Mycobacterium bovis (BCG strain)

{{DISPLAYTITLE:''Mycobacterium bovis'' (BCG strain)}}

== Background ==

* Intravesicular instillation of ''Mycobacterium bovis'' BCG strain is sometimes used to treat bladder cancer
* It can occasionally cause infections, sometimes referred to as BCGitis

== Clinical Manifestations ==

* Median time from instillation to onset of symptoms is [[Incubation period::169 days]][[CiteRef::cabas2021bc]] (range 3 months to many years)
* Disease can disseminate to liver, lungs, bone marrow, bones, joints (in descending order of frequency)
* Localized disease can cause [[cystitis]], bladder contractures, granulomatous prostatitis, prostate abscess, epididymo-orchitis, testicular abscess, pyelonephritis, renal abscess, ureteral stricture, penile granuloma
** Common symptoms are localized bladder irritation (dysuria, frequency, hematuria), with low-grade fevers and malaise
* Systemic spread can cause a sepsis syndrome, pulmonary disease (miliary or interstitial disease), granulomatous hepatitis, osteomyelitis (most commonly the spine), psoas abscess, and (very rarely) vascular complications including arteritis or vasa vasorum or contiguous spread from local infection to the adjacent arteries

=== Local Post-Instillation Reaction ===

* Can have malaise, myalgias, nausea, chills, and low-grade fevers that resolve within 48 hours

== Management ==

* Induction with [[isoniazid]], [[rifampin]], and [[ethambutol]], followed by consolidation with [[isoniazid]] and [[rifampin]]
* Sometimes needs surgery

[[Category:Mycobacteria]]