Systemic bacillus Calmette-Guerin infection in patients treated by intravesical BCG therapy for superficial bladder cancer.
Among 169 patients treated for superficial bladder tumors with intravesical instillations of 150 mg BCG-Pasteur, five developed BCG-itis--a severe systemic infection with bronchopulmonary lesions and granulomatous hepatitis. In four cases, the complication appeared early during treatment (after three, six, six and eight instillations respectively). In one case, BCG-itis appeared 6 months after completion of 2 years monthly maintenance therapy. In addition to pulmonary basal infiltration and granulomatous hepatitis, intramedullary granulomatosis was observed. In three patients, the role of trauma has to be considered, as BCG-itis appeared after a traumatic instillation with bleeding. All patients were cured by combined treatment with Rifampicin, Isoniazid and Prednisolone.
Steg
A
A
Dept. of Urology, Hôpital Cochin, Paris, France.
Leleu
C
C
Debré
B
B
Boccon-Gibod
L
L
Sicard
D
D
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D006099:Granuloma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis; D014376:Tuberculosis / Q000209:etiology*; D014386:Tuberculosis, Hepatic / Q000209:etiology; D014397:Tuberculosis, Pulmonary / Q000209:etiology; D001749:Urinary Bladder Neoplasms / Q000628:therapy*; D014546:Urinary Catheterization / Q000009:adverse effects
D001500:BCG Vaccine