A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer

O. Reigstad; P. Siewers

doi:10.1302/0301-620X.90B2.20038

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A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer

O. Reigstad
P. Siewers

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A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer

Reigstad O, Siewers P. A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer. J Bone Joint Surg Br. 2008;90-B(2):225-227. doi:10.1302/0301-620X.90B2.20038

Reigstad, O., and P. Siewers. “A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer.” The Journal of Bone & Joint Surgery British Volume, vol. 90-B, no. 2, 2008, pp. 225-227., https://doi.org/10.1302/0301-620X.90B2.20038

Reigstad, O., & Siewers, P. (2008). A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer. The Journal of Bone & Joint Surgery British Volume, 90-B(2), 225-227. https://doi.org/10.1302/0301-620X.90B2.20038

Reigstad, O. and Siewers, P. (2008) “A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer.” The Journal of Bone & Joint Surgery British Volume, 90-B(2), pp. 225-227. Available at: https://doi.org/10.1302/0301-620X.90B2.20038

Reigstad, O., and P. Siewers. “A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer.” The Journal of Bone & Joint Surgery British Volume 90-B, no. 2 (2008): 225-227. https://doi.org/10.1302/0301-620X.90B2.20038

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Abstract

An 86-year-old male presented with a loose total hip replacement (THR) ten years after implantation. At revision for anticipated aseptic loosening, watery pus was found in the joint and Bacille-Calmette-Guérin (BCG) was seen on culture. The bacterial strain was identified and was identical to the BCG used in the intravesicular treatment of superficial bladder carcinoma in this patient ten months earlier. After revision he received a full course of antituberculous treatment.

The clinical and radiological results were excellent after follow-up for 30 months with his uncemented THR showing satisfactory incorporation. His inflammatory markers were normal and his Harris hip score was 95 points.

The diagnosis of a tuberculous infection can be easily missed, but must be considered, especially if sterile pus is encountered.

Correspondence should be sent to Dr O. Reigstad; e-mail: ole.reigstad@rikshospitalet.no

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