Spectrum of bacille Calmette-Guérin (BCG) infection after intravesical BCG immunotherapy.
Intravesical instillation of bacille Calmette-Guérin (BCG) effectively treats transitional cell carcinoma of the bladder. Occasionally, BCG infection complicates such treatment. In some patients, infection appears early (within 3 months after instillation) and is characterized by generalized symptoms, with pneumonitis and hepatitis. Late-presentation disease occurs >1 year after the first BCG treatment and usually involves focal infection of the genitourinary tract (the site at which bacteria were introduced) and/or other sites that are typical for reactivation of mycobacterial disease, such as the vertebral spine or the retroperitoneal tissues. Noncaseating granulomas are found in the majority of cases, whether early or late. Most patients respond to treatment with antituberculous drugs; in early-presentation disease, when features of hypersensitivity predominate, glucocorticosteroids are sometimes added. Late localized infection often requires surgical resection.
Gonzalez
Omar Y
OY
Department of Medicine, Infectious Disease Section, Baylor College of Medicine, Houston, TX 77030-3498, USA.
Musher
Daniel M
DM
Brar
Indira
I
Furgeson
Seth
S
Boktour
Maha R
MR
Septimus
Edward J
EJ
Hamill
Richard J
RJ
Graviss
Edward A
EA
D000328:Adult; D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy; D006505:Hepatitis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D009163:Mycobacterium bovis; D011014:Pneumonia / Q000188:drug therapy / Q000209:etiology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy
D001500:BCG Vaccine