2022
DOI: 10.4236/aid.2022.123041
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Genitourinary Bacillus Calmette-Guerin Infection after BCG Intravesical Administration in a Patient under Hemodialysis — What Can We Do Better?

Abstract: A 74-year-old man with terminal chronic kidney disease, under hemodialysis and with residual diuresis, was admitted due to myalgia, arthralgia, fever and pyuria in the previous 10 days. The patient had a recent diagnosis of high-grade non-invasive bladder cancer and was doing weekly BCG intravesical administrations. The symptoms started three days before the fifth administration. He had done cefixime as an outpatient and started piperacillin-tazobactam on hospital admission, but the fever persisted, and there … Show more

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“…Although data are still lacking, the presence of underlying immunosuppression [ 6 , 14 ] or low or no residual diuresis, both present in our patient, are also considered potential risk factors for local and systemic complications, due to a longer stay of BCG in the bladder [ 14 ]. Nonetheless, reduced doses don’t look to decrease toxicity and long-duration protocols do not lead to increased toxicity [ 4 ].…”
Section: Discussionmentioning
confidence: 99%
“…Although data are still lacking, the presence of underlying immunosuppression [ 6 , 14 ] or low or no residual diuresis, both present in our patient, are also considered potential risk factors for local and systemic complications, due to a longer stay of BCG in the bladder [ 14 ]. Nonetheless, reduced doses don’t look to decrease toxicity and long-duration protocols do not lead to increased toxicity [ 4 ].…”
Section: Discussionmentioning
confidence: 99%