Four cases of disseminated Mycobacterium bovis infection following intravesical BCG instillation for treatment of bladder carcinoma.


:Intravesical BCG (bacillus Calmette-Guérin) instillation is a first-line treatment for superficial transitional cell carcinoma of the bladder. A rare but severe complication of BCG immunotherapy is the development of disseminated BCG disease, which can result in miliary pneumonitis, granulomatous hepatitis, soft tissue infections, bone marrow involvement, and sepsis. Symptoms can present as early as a few hours or as late as several months following the BCG therapy. The key finding in disseminated BCG disease is the formation of caseating granulomas in distant organs; detection of BCG organisms from tissue samples can be difficult. Recommended treatment for disseminated BCG disease includes a combination of antituberculous medications (with the exception of pyrazinamide, to which BCG is typically resistant) and a tapering course of steroids. We present the cases of four patients who developed granulomatous infection consistent with disseminated disease after intravesical BCG treatment and provide a summary of current clinical management recommendations.


South Med J


Southern medical journal


Nadasy KA,Patel RS,Emmett M,Murillo RA,Tribble MA,Black RD,Sutker WL




Has Abstract


2008-01-01 00:00:00














  • Neurologic abnormalities in a patient with human ehrlichiosis.

    abstract::Human ehrlichiosis is a tick-borne rickettsial disease characterized by fever, headache, myalgias, anorexia, and occasionally rash. In our patient, changes in mental status, upper motor neuron signs, cerebrospinal fluid pleocytosis, and increased serum protein levels were found in association with serologically confir...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Harkess JR,Stucky D,Ewing SA

    更新日期:1990-11-01 00:00:00

  • A case of congestive heart failure due to reversible dilated cardiomyopathy caused by hyperthyroidism.

    abstract::Thyrotoxicosis is an uncommon cause of low-output congestive heart failure. The case of a 41-year-old male who presented with severe symptomatic congestive heart failure, and was subsequently diagnosed with dilated cardiomyopathy secondary to hyperthyroidism, is presented. The cause of his hyperthyroidism was Graves d...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Khandwala HM

    更新日期:2004-10-01 00:00:00

  • Intestinal antisepsis.

    abstract::The role of antibiotics in large bowel surgery was established by experimental studies indicating that antibiotics could protect a colonic anastomosis subjected to unusual stress. A number of different agents were studied to patients to determine which ones significantly altered the bacterial flora of the colon. Clini...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Cohn I Jr

    更新日期:1982-12-01 00:00:00

  • Use of a national data base to assess perioperative risk, morbidity, mortality, and cost savings in coronary artery bypass grafting.

    abstract::To show the usefulness of the Society of Thoracic Surgeons (STS) National Database in providing clinical and cost-related outcome data, we studied 297 consecutive patients who had isolated coronary artery bypass grafting (CABG) and who were assigned to either a "fast track" or traditional track. The observed overall m...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Nikas DJ,Freeman JE,Luterman AR,Warnken LC,Nenstiel RD,Farrell M,Alpert MA

    更新日期:1996-11-01 00:00:00

  • Diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone.

    abstract:BACKGROUND:Hyponatremia is a frequent condition in elderly patients. In diagnostic workup, a 24-hour urine sample is used to measure urinary osmolality and urinary sodium concentration necessary to confirm the diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This study was undertake...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Holm EA,Bie P,Ottesen M,Ødum L,Jespersen B

    更新日期:2009-04-01 00:00:00

  • Intrathoracic chordoma presenting as a posterior mediastinal tumor.

    abstract::Chordomas are tumors originating from remnants of the notochord, most commonly found in the cranial and caudal regions. This is a report of the seventh intrathoracic chordoma in the world literature and the second to be reported in a woman. Histologically the physalipherous (blister-bearing) cell is characteristic of ...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Castellano GC,Johnston HW

    更新日期:1975-01-01 00:00:00

  • Point-of-Care Ultrasound in Established Settings.

    abstract::The original and most widely accepted applications for point-of-care ultrasound (POCUS) are in the settings of trauma, shock, and bedside procedures. Trauma was the original setting for the introduction of POCUS and has been standardized under the four-plus view examination called the Focused Assessment with Sonograph...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Morrow D,Cupp J,Schrift D,Nathanson R,Soni NJ

    更新日期:2018-07-01 00:00:00

  • Water Load Test in Children with Chronic Abdominal Pain or Obesity Compared with Nonobese Controls.

    abstract:OBJECTIVE:Satiety is the perception of satisfied fullness and represents a summation of neural and hormonal influences. Satiety can be assessed by drink tests, including water load. The objective of our study was to confirm the difference in water load volume between nonobese control children and children with function...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Arrouk R,Karpinski A,Lavenbarg T,Belmont J,McCallum RW,Hyman P

    更新日期:2017-03-01 00:00:00

  • Dementia: physician approaches to the caregiver's problems.

    abstract::The demented patient requires medical and often psychiatric supervision, but the caregiver is often neglected. This article identifies special issues for caregivers that may need attention from the demented patient's physician. The physician's attention can benefit both the patient and the caregiver and save the physi...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Greene JA,Taylor SE,Johnson W

    更新日期:1993-09-01 00:00:00

  • Topical clotrimazole in tinea pedis.

    abstract::Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis, cutaneous candidiasis, and tinea vesicolor. The authors performed a controlled double-blind clinical trial comparing topical clotrimazole with its vehicle in the treatment of 66 patients with dermatophytic infections of the skin of...

    journal_title:Southern medical journal

    pub_type: 临床试验,杂志文章


    authors: Smith EB,Graham JL,Ulrich JA

    更新日期:1977-01-01 00:00:00

  • The development, status, and future of healthcare chaplaincy.

    abstract::This review article provides insight into the evolution of professional healthcare chaplaincy. It identifies key historical developments identifying the training, qualifications, and competencies of chaplains. Consideration is given to both the unique character of the pastoral role in healthcare as well as the contrib...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Ford T,Tartaglia A

    更新日期:2006-06-01 00:00:00

  • Use of cetirizine in a 23-month-old male causes insomnia.

    abstract::Allergic rhinitis affects approximately 40% of children and generally presents in children from 10-19 years of age; however, the condition has been seen in children as young as 6 months. Antihistamines are commonly prescribed in infants and children for the relief of allergic symptoms. A 23-month-old male with a histo...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Jones MC,Jones CE 2nd

    更新日期:2010-05-01 00:00:00

  • Current concerns for blood donor well-being and health.

    abstract::In addition to assuring an adequate and safe blood supply, blood collection agencies are responsible for the well being of donors. Several aspects of the current blood donor experience may negatively impact donor health and require modification. Physicians need to be aware of health-related issues associated with bloo...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Reiss RF,Kessler D

    更新日期:2010-04-01 00:00:00

  • Roentgenographic evaluation of the augmented breast.

    abstract::We performed a retrospective study to determine the sensitivity of mammography in detecting breast cancer arising in women with augmented breasts. Of eight women with breast implants in whom breast cancer developed, six had mammograms before biopsy. Only two of the six cancers were identified mammographically (sensiti...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Douglas KP,Bluth EI,Sauter ER,McKinnon WM,Bergeron RB,Merritt CR,Sullivan MA,Finley JM

    更新日期:1991-01-01 00:00:00

  • Hypertension and primary hyperparathyroidism: a five-year case review.

    abstract::All cases of surgically proven and cured primary hyperparathyroidism, over a five-year period, were reviewed for the presence of hypertension, renal and/or prerenal azotemia, nephrolithiasis, nephrocalcinosis, and patient symptom status. In this group of 23 patients, the prevalence of hypertension was greater than 78%...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Lueg MC

    更新日期:1982-11-01 00:00:00

  • Primary squamous cell carcinoma of the breast.

    abstract::Primary squamous cell carcinoma of the breast is a rare cancer. Published reports of prognosis are variable, and most studies are case reports of one or a few patients. We report an additional case of squamous cell carcinoma of the breast occurring in a 53-year-old black woman. In reviewing the reported cases of this ...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Weigel RJ,Ikeda DM,Nowels KW

    更新日期:1996-05-01 00:00:00

  • Aberrant internal carotid artery.

    abstract::An aberrant internal carotid artery (ICA) in the middle ear is rare. If unrecognized, it may lead to massive hemorrhage or other catastrophic results during even a minor surgical procedure of the tympanic membrane or middle ear. Recognition of this entity is particularly significant to the primary care or emergency de...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Cole RD,May JS

    更新日期:1994-12-01 00:00:00

  • Pulmonary vein obstruction by bronchogenic carcinoma.

    abstract::Two patients with obstruction of the pulmonary veins by bronchogenic carcinoma, an unusual cause, are presented. These and other cases reported have had features suggestive of mitral stenosis. The differential diagnosis is discussed. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Stinson JM,Goodwin RA Jr

    更新日期:1976-11-01 00:00:00

  • Impact of Do-Not-Resuscitate Orders on Nursing Clinical Decision Making.

    abstract:OBJECTIVES:Code status specifies the action that healthcare providers should take in the event of cardiac arrest. Studies have shown, however, that patients with do-not-resuscitate/do-not-intubate (DNR/DNI) orders have worse outcomes and do not consistently receive the standard of care. Several studies have demonstrate...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Engels R,Graziani C,Higgins I,Thompson J,Kaplow R,Vettese TE,Massart A

    更新日期:2020-07-01 00:00:00

  • Hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone: rapid correction with osmotic agents.

    abstract::In three patients with SIADH, mannitol or glycerol promoted a rapid free water diuresis. Use of osmotic agents requires less laboratory and clinical monitoring than use of furosemide, is appropriate treatment, and in fact may be the treatment of choice in some patients with symptomatic hyponatremia from SIADH. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Weinberg MS,Donohoe JF

    更新日期:1985-03-01 00:00:00

  • Colorectal cancer in patients 20 years old or less in Taiwan.

    abstract:BACKGROUND:Colorectal cancer (CRC) is predominantly a disease of the elderly population, but it sometimes occurs in young patients. The diagnosis of CRC in youngsters is often overlooked by physicians or presentation may be delayed. METHODS:With assistance from the cancer registry center of Taipei Veterans General Hos...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Chen LK,Hwang SJ,Li AF,Lin JK,Wu TC

    更新日期:2001-12-01 00:00:00

  • Pediatric analgesia with epidural fentanyl citrate administered by nursing staff.

    abstract::Even though epidural analgesia is effective and has advantages over conventional postoperative analgesia, it is also labor intensive, requiring 24-hour supervision by an anesthesiologist. In an effort to decrease the manpower requirements, some hospitals allow the nursing staff to administer epidural narcotics to adul...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Tobias JD,Oakes L,Austin BA

    更新日期:1992-04-01 00:00:00

  • Treatment options for the management of perennial allergic rhinitis, with a focus on intranasal corticosteroids.

    abstract::Perennial allergic rhinitis (PAR) can have a significant impact on a patient's quality of life. While allergen avoidance is the first line of management for PAR, complete avoidance is difficult. Therapeutic options available for PAR include intranasal corticosteroids (INS), H1-antihistamines, decongestants and local c...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Brunton SA,Fromer LM

    更新日期:2007-07-01 00:00:00

  • Exceptionally high arterial oxygen tension in diabetic ketoacidosis.

    abstract::We recently managed a patient with diabetic ketoacidosis who had an exceptionally high arterial oxygen tension of 144 mm Hg while breathing room air. This was higher than the calculated alveolar oxygen tension and suggested the impossible situation of an uphill diffusion gradient. We were surprised to find this is a r...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Kelton JG,Collins FF

    更新日期:1979-09-01 00:00:00

  • Pancreatic pseudocyst with splenic involvement: an uncommon complication of pancreatitis.

    abstract::We have presented a case of chronic pancreatitis with pseudocyst involvement of the spleen complicated by splenic rupture. This complication is uncommon, only 19 cases having been reported. As illustrated by our case, there is a high risk of hemorrhage from a pseudocyst involving the spleen and pancreas. Immediate sur...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: McMahon NG,Norwood SH,Silva JS

    更新日期:1988-07-01 00:00:00

  • Rhegmatogenous retinal detachment complicating diabetic retinopathy.

    abstract::Retinal detachment complicating proliferative diabetic retinopathy is being recognized with increasing frequency. Although one type of detachment is tractional and requires vitrectomy for hopeful repair, the other variety of detachment is rhegmatogenous. The rhegmatogenous form of retinal detachment does not generally...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审


    authors: Humphrey WT

    更新日期:1978-10-01 00:00:00

  • HIV antibody testing in hospitalized patients.

    abstract::We retrospectively reviewed the charts of 190 hospitalized patients who had human immunodeficiency virus (HIV) antibody testing at our medical center in 1986 and 1987. From 1986 to 1987, HIV antibody testing increased fourfold based on total hospital discharges. Nine patients (5%) tested positive by enzyme immunoassay...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Manian FA,Rinke D

    更新日期:1990-01-01 00:00:00

  • Black/white differential use of health services by young children in a rural Mississippi community.

    abstract:BACKGROUND AND OBJECTIVES:Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community. METHODS:Data were prospectively collected for 396 children attending a private practice to determine if race was associated wi...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Kum-Nji P,Mangrem CL,Wells PJ,Klesges LM,Herrod HG

    更新日期:2006-09-01 00:00:00

  • Altered sensorium, confusion, and vertical gaze paresis: the top of the basilar syndrome.

    abstract::The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Gomez CR,Hogan PA,Cruz-Rodriguez RF,Jumao-As AP

    更新日期:1988-07-01 00:00:00

  • Intermittent obstruction of jejunostomy tube due to Ascaris lumbricoides infection.

    abstract::A 45-year-old Costa Rican woman was seen for a jejunostomy tube malfunction. There was no evidence of tube malposition or intestinal obstruction. During endoscopy, a long worm was retrieved from the distal duodenum; it was later confirmed to be Ascaris lumbricoides. After treatment with mebendazole, no further episode...

    journal_title:Southern medical journal

    pub_type: 杂志文章


    authors: Kiafar C,Shah D,Wadas D,Gilani N

    更新日期:2008-06-01 00:00:00