BCGitis of the wrist after intravesical BCG therapy: A case report

Hand Surg Rehabil. 2020 Dec;39(6):585-587. doi: 10.1016/j.hansur.2020.05.011. Epub 2020 Jul 10.

Abstract

Septic arthritis of the wrist can result in joint destruction, making timely diagnosis crucial for initiating empiric antibiotics and surgical intervention. Mycobacterium is a rare cause of this disorder. A 47-year-old man with bladder cancer was treated surgically and received BCG intravesical therapy. Eleven months later, this patient developed severe carpal BCGitis requiring total carpal resection. The first step was addition of a cement spacer and radiometacarpal stabilisation (Masquelet technique). Secondary infections occurred aggravating the prognosis. This case emphasises the importance of taking into account the patient's medical history. Tuberculosis of the wrist is a rare etiology for septic arthritis; delayed treatment leads to severe complications and functional sequelae.

Keywords: BCGite; BCGitis; Carpectomie; Carpectomy; Infection du poignet; Osteoarthritis of the wrist; Ostéite du poignet; Ostéoarthrite du poignet; Ostéomyélite du poignet; Tuberculose; Tuberculosis; Wrist infection; Wrist osteitis; Wrist osteomyelitis.

Publication types

  • Case Reports

MeSH terms

  • Antibiotics, Antitubercular / therapeutic use
  • Arthritis, Infectious / microbiology*
  • Arthritis, Infectious / therapy*
  • BCG Vaccine / adverse effects*
  • Carpal Bones / surgery
  • Ethambutol / therapeutic use
  • Humans
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Mycobacterium bovis / isolation & purification
  • Rifampin / therapeutic use
  • Surgical Flaps
  • Synovectomy
  • Tuberculosis, Osteoarticular / etiology
  • Tuberculosis, Osteoarticular / therapy*
  • Urinary Bladder Neoplasms / drug therapy
  • Wrist Joint / microbiology*
  • Wrist Joint / surgery

Substances

  • Antibiotics, Antitubercular
  • BCG Vaccine
  • Ethambutol
  • Isoniazid
  • Rifampin