Open Access

CASE REPORT

Tuberculous epididymitis following intravesical Bacillus Calmette-Guérin immunotherapy

Nathan Hoag¹, Peter J. Pommerville¹, Pamela C. Kibsey², Douglas J. Cavers³, Richard J. Eddy⁴

1 Department of Urologic Sciences, University of British Columbia (Island Medical Program), Victoria, BC, Canada
2 Department of Laboratory Medicine, Vancouver Island Health Authority, Victoria, BC, Canada
3 Department of Laboratory Services, Royal Jubilee Hospital, Victoria, BC, Canada
4 Department of Medical Imaging, Royal Jubilee Hospital, Victoria, BC, Canada
Address correspondence to Nathan Hoag BSc, University of British Columbia (Island Medical Program), University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2 Canada

Canadian Journal of Urology 2009, 16(2), 4589-4591.

Abstract

Intravesical Bacillus Calmette-Guérin (BCG) is widely used as an adjuvant therapy in the treatment of superfi cial bladder cancer. BCG is administered as a live, attenuated form of Mycobacterium bovis, and acts as an immunomodulary agent to delay tumor progression. BCG is generally well tolerated, though localized and systemic infectious complications may occur. A literature search revealed that tuberculous epididymitis is a rarely reported complication of intravesical BCG therapy. We report the case of an 82-year-old male who developed tuberculous epididymitis while undergoing intravesical BCG treatment for transitional cell carcinoma of the bladder. Right orchiectomy was performed, followed by rifampin and isoniazid therapy once M. bovis was identifi ed as the infectious agent. The patient responded well to these treatments, and made a full recovery. Tuberculous epididymitis is an uncommon complication resulting from intravesical BCG therapy, which is likely explained by retrograde migration from the prostatic urethra in this case.

---

Keywords

---