Systemic bacillus Calmette-Guérin infection, 'BCGitis', in patients treated by intravesical bacillus Calmette-Guérin therapy for bladder cancer.
Among 169 patients treated for supeficial bladder tumor with 150 mg Pasteur-strain bacillus Calmette-Guérin (BCG) intravesical instillation, 5 cases of 'BCGitis' were observed, i.e. a severe systemic BCG infection with bronchopulmonary lesions and granulomatous hepatitis. In 4 cases, the complications appeared at the early stage of treatment (after the 3rd, 6th, 6th and 8th instillations, respectively). In 1 case, treated with monthly maintenance therapy for 2 years, BCGitis appeared 6 months after treatment had been completed and, in addition to pulmonary basal infiltrate and granulomatous hepatitis, intramedullary granulomatosis was observed. In 3 patients, trauma must be taken into consideration as BCGitis appeared after traumatic instillation with bleeding. All patients were cured by treatment with rifampicin, isoniazid and prednisone.
Steg
A
A
Department of Urology, Hôpital Cochin, Paris, France.
Leleu
C
C
Debré
B
B
Boccon-Gibod
L
L
Sicard
D
D
D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D001500:BCG Vaccine; D011239:Prednisolone; D007538:Isoniazid; D012293:Rifampin