Sep 7, 2018
This episode discusses the case of an 85-year-old man with a
history of hypertension and fairly recently diagnosed bladder
cancer who presents with oligoarticular asymmetric inflammatory
arthritis. Explore the details of this case and learn how bacillus
Calmette-Guérin and reactive arthritis are related in this
- Intro :10
- An 85-year-old man with a history of hypertension and recently
diagnosed bladder cancer presents with oligoarticular asymmetric
inflammatory arthritis :18
- Details of his cancer history
- How BCG (bacillus Calmette-Guérin) is used for superficial
bladder cancer :53
- Patient wakes with acute onset, rapidly progressing joint pain
- Results of synovial aspiration of his right wrist
- Physical exam findings and patient history
- Discharged from outside hospital
- Outpatient rheumatologist orders autoimmune serologies
- Second hospital admission 3:24
- Infectious disease evaluation
- Patient presents to Cleveland Clinic
- What do we have? 6:18
- The main concern is he’s been instilled with bacteria
- Could this be a reactive arthritis?
- History of BCG 7:45
- What do we know about what happens to these patients?
- How do we define disseminated BCG infection vs. a reactive
- A single institution cohort of disseminated infection after BCG
- Comparing these definitions in our patient
- A look at reactive arthritis
- What do we use to treat these patients?
- A look back at our patient 16:31
- Continued treatment with triple therapy
- A diagnostic conundrum 17:32
- The diagnosis, in hindsight
- Summary 18:49
We’d love to hear from you! Send your comments/questions to
Bernini L. Autoimmun Rev. 2013;12:1150-1159.
Postgrad Med J. 2002;78:449-454.
Pérez-Jacoiste Asín MA. Medicine (Baltimore).
To U. Case Rep Med.