Mycobacterium bovis endophthalmitis from BCG immunotherapy for bladder cancer.
BACKGROUND
We report a patient who developed BCG endophthalmitis after BCG immunotherapy for bladder cancer. Comparison of this case with 2 other reported cases reveals a similar pattern of elderly, debilitated and immunocompromised patients with poor response to systemic antituberculous therapy in whom systemic steroids are used concurrently. Age and glucocorticoids are known to lead to thymic involution, reduce cell mediated immunity, and a lowering in the number of naive T cells capable of mounting an effective defense to new infectious agents.


CONCLUSIONS
Physicians should be aware of the potential for ocular complications of BCG immunotherapy in the elderly, immunocompromised, on oral steroids.
Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. fgerbrandy@hotmail.com
S J F
SJ
Gerbrandy
L C
LC
Schreuders
M D
MD
de Smet
D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000188:drug therapy*; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007167:Immunotherapy; D008297:Male; D009163:Mycobacterium bovis; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000188:drug therapy; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D014392:Tuberculosis, Ocular / Q000139:chemically induced*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000188:drug therapy*
D001500:BCG Vaccine; D005938:Glucocorticoids; D011239:Prednisolone