title: Tubercular disease caused by Bacillus of Calmette-Guérin as a local adjuvant treatment of relapsing bladder carcinoma.
abstract: Two (2) exemplary case reports of respiratory granulomatous infection caused by Bacillus of Calmette-Guérin (BCG), in patients who were repeatedly treated with local, intravesical adjuvant BCG therapy for a relapsing transitional bladder carcinoma, are outlined and discussed on the grounds of the cumbersome diagnostic and differential diagnostic process (especially when a prior tuberculosis and a concurrent chronic obstructive pulmonary disease are of concern), along with an updated literature revision. Only 4 cases of respiratory BCG-itis (pulmonary tuberculosis-like forms) have been reported, to date, to the best of our knowledge (2 of them following the bladder instillation of BCG). One (1) episode of ours represents the first described case with a dual, concomitant granulomatous localization of BCG-itis, also involving the genitourinary tract.
authors.affiliation: Department of Internal Medicine, Aging, and Nephrologic Diseases, Division of Infectious Diseases, Alma Mater Studiorum University of Bologna, S. Orsola-Malpighi Hospital, I-40138 Bologna, Italy. Roberto.manfredi@unibo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.forename: Nicola
authors.initials: N
authors.lastname: Dentale
authors.forename: Benedetta
authors.initials: B
authors.lastname: Piergentili
authors.forename: Cristian
authors.initials: C
authors.lastname: Pultrone
authors.forename: Eugenio
authors.initials: E
authors.lastname: Brunocilla
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014376:Tuberculosis / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000628:therapy*
chemical_list: D001500:BCG Vaccine