title: [Acute respiratory failure and septic shock induced by Mycobacterium bovis. A rare side effect of intravesical BCG therapy].
abstract: BACKGROUND
  Intravesical bacillus Calmette-Guerin (BCG) therapy, recommended for superficial bladder tumors, triggers side effects in fewer than 5% of patients. The most severe side effects, however, are septic shock and acute respiratory failure.
  
  
  METHODS
  A 70-year-old man was hospitalized for septic shock with acute respiratory and renal failure after intravesical instillation of BCG, which was identified in the gastric aspiration sample. Treatment with rifampicin, ethambutol, isoniazid, and corticosteroid therapy, as well as standard reanimation measures, led to the patient's recovery.
  
  
  CONCLUSIONS
  This case shows the potentially severe side effects of intravesical BCG instillation. Although this treatment is well tolerated in more than 95% of patients and its systemic complications can be effectively treated, these side effects can be life-threatening.
authors.affiliation: Université François-Rabelais, Réanimation médicale, CHU Bretonneau, Tours (37). gilles.rival@wanadoo.fr
authors.forename: Gilles
authors.initials: G
authors.lastname: Rival
authors.forename: Denis
authors.initials: D
authors.lastname: Garot
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Mercier
authors.forename: Bérangère
authors.initials: B
authors.lastname: Narciso
authors.forename: Annick
authors.initials: A
authors.lastname: Legras
authors.forename: Dominique
authors.initials: D
authors.lastname: Perrotin
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Dequin
mesh_terms: D000208:Acute Disease; D000283:Administration, Intravesical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002443:Ceftriaxone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D015242:Ofloxacin / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000382:microbiology*; D012772:Shock, Septic / Q000382:microbiology*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D001500:BCG Vaccine; D002443:Ceftriaxone; D015242:Ofloxacin