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Meije Y, Martínez-Montauti J, Caylà JA, Loureiro J, Ortega L, Clemente M, Sanz X, Ricart M, Santomà MJ, Coll P, Sierra M, Calsina M, Vaqué M, Ruiz-Camps I, López-Sánchez C, Montes M, Ayestarán A, Carratalà J, Orcau À. Healthcare-Associated Mycobacterium bovis-Bacille Calmette-Guérin (BCG) Infection in Cancer Patients Without Prior BCG Instillation. Clin Infect Dis 2019; 65:1136-1143. [PMID: 28575173 DOI: 10.1093/cid/cix496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/23/2017] [Indexed: 11/14/2022] Open
Abstract
Background Bacille Calmette-Guérin (BCG), an attenuated strain of Mycobacterium bovis, is widely used as adjunctive therapy for superficial bladder cancer. Intravesical administration of BCG has been associated with systemic infection. Disseminated infection due to M. bovis is otherwise uncommon. Methods After identification of 3 patients with healthcare-associated BCG infection who had never received intravesical BCG administration, an epidemiologic study was performed. All patients with healthcare-associated BCG infection in the Barcelona tuberculosis (TB) program were reviewed from 1 January 2005 to 31 December 2015, searching for infections caused by M. bovis-BCG. Patients with healthcare-associated BCG infection who had not received intravesical BCG instillation were selected and the source of infection was investigated. Results Nine oncology patients with infection caused by M. bovis-BCG were studied. All had permanent central venous catheters. Catheter maintenance was performed at 4 different outpatient clinics in the same room in which other patients underwent BCG instillations for bladder cancer without required biological precautions. All patients developed pulmonary TB, either alone or with extrapulmonary disease. Catheter-related infection was considered the mechanism of acquisition based on the epidemiologic association and positive catheter cultures for BCG in patients in whom mycobacterial cultures were performed. Conclusions Physicians should be alerted to the possibility of TB due to nosocomially acquired, catheter-related infections with M. bovis-BCG in patients with indwelling catheters. This problem may be more common than expected in centers providing BCG therapy for bladder cancer without adequate precautions.
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Affiliation(s)
- Yolanda Meije
- Infectious Disease Unit, Internal Medicine Department, and
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
| | - Joaquín Martínez-Montauti
- Infectious Disease Unit, Internal Medicine Department, and
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
| | - Joan A Caylà
- Epidemiology Service. Public Health Agency of Barcelona and CIBER de Epidemiologia y Salud Pública
| | - Jose Loureiro
- Infectious Disease Unit, Internal Medicine Department, and
| | - Lucía Ortega
- Infectious Disease Unit, Internal Medicine Department, and
| | - Mercedes Clemente
- Infectious Disease Unit, Internal Medicine Department, and
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
| | - Xavier Sanz
- Infectious Disease Unit, Internal Medicine Department, and
| | - Montserrat Ricart
- Epidemiology Service. Public Health Agency of Barcelona and CIBER de Epidemiologia y Salud Pública
| | - María J Santomà
- Epidemiology Service. Public Health Agency of Barcelona and CIBER de Epidemiologia y Salud Pública
| | - Pere Coll
- Microbiology Department, Fundació de Gestió Sanitaria del Hospital de la Santa Creu i Sant Pau
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, and
- Institut d'Investigació Biomèdica Sant Pau, Barcelona
- Spanish Network for the Research in Infectious Diseases, Madrid
| | - Montserrat Sierra
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
- Microbiology Department, Hospital de Barcelona, SCIAS
| | - Marta Calsina
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
| | - Montserrat Vaqué
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
| | | | | | - Mar Montes
- Pharmacy Department, Hospital de Barcelona, SCIAS
| | - Ana Ayestarán
- Joint Commission for the Infectious Disease Management, Control and Prevention, Hospital de Barcelona, Societat Cooperativa d'Installacions Assistencials Sanitàries (SCIAS)
- Pharmacy Department, Hospital de Barcelona, SCIAS
| | - Jordi Carratalà
- Spanish Network for the Research in Infectious Diseases, Madrid
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, and
- Department of Clinical Sciences, University of Barcelona, Spain
| | - Àngels Orcau
- Epidemiology Service. Public Health Agency of Barcelona and CIBER de Epidemiologia y Salud Pública
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Calsina M, Philipone E, Patwardhan M, Eisig S, Prat J, Kazim M. Solitary orbital myofibroma: clinical, radiographic, and histopathologic findings. A report of two cases. Orbit 2011; 30:180-2. [PMID: 21780929 DOI: 10.3109/01676830.2011.574773] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This describes a non-interventional case series of 2 patients, aged 7 and 9 years referred to Oculoplastic Unit, both for evaluation of a gradually enlarging, painless, mass of the cheek. CT scan of the first case revealed left orbital floor destruction from a well-defined intraosseous mass. The second was a round circumscribed orbital floor tumor without bone destruction. Histological diagnosis of myofibroma was rendered in both cases. Solitary myofibromas are rare in the orbit. Their rapid growth and bony destruction can mimic malignant tumors. Complete excision with close follow-up is the preferred treatment. Solitary myofibroma should be considered in the differential diagnoses of fibrous tumors with bone destruction in the orbit.
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Affiliation(s)
- Marta Calsina
- Department of Ophthalmology, Division of Ophthalmic Plastic and Reconstructive Surgery, Edward S. Harkness Eye Institute, Columbia College of Physicians and Surgeons, and Columbia Presbyterian Hospital, New York Eye Center, Ophthalmology, New York, NY 10038, USA.
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