Systemic bacillus Calmette-Guérin infection, 'BCGitis', in patients treated by intravesical bacillus Calmette-Guérin therapy for bladder cancer

Eur Urol. 1989;16(3):161-4. doi: 10.1159/000471561.

Abstract

Among 169 patients treated for supeficial bladder tumor with 150 mg Pasteur-strain bacillus Calmette-Guérin (BCG) intravesical instillation, 5 cases of 'BCGitis' were observed, i.e. a severe systemic BCG infection with bronchopulmonary lesions and granulomatous hepatitis. In 4 cases, the complications appeared at the early stage of treatment (after the 3rd, 6th, 6th and 8th instillations, respectively). In 1 case, treated with monthly maintenance therapy for 2 years, BCGitis appeared 6 months after treatment had been completed and, in addition to pulmonary basal infiltrate and granulomatous hepatitis, intramedullary granulomatosis was observed. In 3 patients, trauma must be taken into consideration as BCGitis appeared after traumatic instillation with bleeding. All patients were cured by treatment with rifampicin, isoniazid and prednisone.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravesical
  • Aged
  • BCG Vaccine / adverse effects*
  • BCG Vaccine / therapeutic use
  • Carcinoma, Transitional Cell / therapy*
  • Humans
  • Isoniazid / therapeutic use
  • Male
  • Prednisolone / therapeutic use
  • Rifampin / therapeutic use
  • Time Factors
  • Tuberculosis / drug therapy
  • Tuberculosis / etiology*
  • Urinary Bladder Neoplasms / therapy*

Substances

  • BCG Vaccine
  • Prednisolone
  • Isoniazid
  • Rifampin