Osteoarticular side effects of BCG therapy

Area of Science:

• Immunology
• Oncology
• Rheumatology

Background:

• Bacillus Calmette-Guérin (BCG) is widely used for vaccination and cancer treatment.
• Osteoarticular side effects, though rare, are a notable complication.
• Both BCG vaccination and intravesical BCG therapy for bladder cancer can lead to these issues.

Purpose of the Study:

• To review the osteoarticular complications associated with Bacillus Calmette-Guérin (BCG) therapy.
• To differentiate between reactive arthritis and septic arthritis following BCG treatment.
• To outline recommended treatment strategies for BCG-induced osteoarticular conditions.

Main Methods:

• Literature review of BCG-induced osteoarticular side effects.
• Analysis of clinical presentation distinguishing reactive arthritis from septic arthritis.
• Summary of treatment protocols for BCG-related joint infections and arthritis.

Main Results:

• BCG therapy can manifest as arthralgia, reactive arthritis, or osteoarticular infections.
• Distinguishing reactive from septic arthritis relies on clinical features and joint fluid analysis.
• Reactive arthritis typically responds to nonsteroidal anti-inflammatory drugs.

Conclusions:

• BCG-induced osteoarticular infections require prolonged antibiotic treatment (e.g., rifampin, isoniazid, ethambutol).
• Reactive arthritis often resolves with conservative management.
• Prompt recognition and management are crucial for favorable outcomes in BCG-related osteoarticular complications.