Nearly fatal complications of cervical lymphadenitis following BCG immunotherapy for superficial bladder cancer.
This report describes the case of a 68-year-old man with bilateral cervical lymphadenitis and chorioretinitis due to bacille Calmette-Guérin (BCG), originating from BCG immunotherapy for treatment of superficial bladder cancer 2 years ago. During antimycobacterial therapy a fistula between the right-sided lymph node and an aneurysm of the carotid artery developed. This led to life-threatening spontaneous bleeding which required vascular graft surgery. Like other known systemic side effects, cervical lymphadenitis may also occur following intravesical BCG immunotherapy, and life-threatening complications cannot be excluded despite adequate medical treatment.
Geldmacher
H
H
Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Wöhrendamm 80, D-22827 Grosshansdorf, Germany. Hgeldmache@aol.com
Taube
C
C
Markert
U
U
Kirsten
D K
DK
D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000209:etiology / Q000601:surgery; D005402:Fistula / Q000209:etiology / Q000601:surgery; D006801:Humans; D016233:Immunotherapy, Active / Q000009:adverse effects*; D008198:Lymph Nodes / Q000473:pathology; D008199:Lymphadenitis / Q000150:complications* / Q000209:etiology / Q000382:microbiology; D008297:Male; D009333:Neck; D014456:Ulcer / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D001500:BCG Vaccine