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

Abstract:

: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.

journal_name

South Med J

journal_title

Southern medical journal

authors

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

doi

10.1097/SMJ.0b013e31815d4047

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

91-5

issue

1

eissn

0038-4348

issn

1541-8243

pii

00007611-200801000-00029

journal_volume

101

pub_type

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