Miliary pulmonary tuberculosis following intravesical BCG therapy: case report and literature review

Colmenero, Juan; Sanjuán-Jiménez, Rocío; Ramos, B.; Morata, Pilar

doi:10.1016/j.diagmicrobio.2012.05.026

Cited by 23 publications

(21 citation statements)

References 16 publications

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“…This test does not require any prior culturing of bacillus. The observed side effects are rare [3,9,10]. They can be divided into: (1) infectious (infection) and (2) non-infectious (inflammation).…”

Section: Discussionmentioning

confidence: 99%

Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Białecki¹,

Nowak-Misiak²,

Rapała

et al. 2016

Neurologia i Neurochirurgia Polska

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Section: Discussionmentioning

confidence: 99%

Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Białecki¹,

Nowak-Misiak²,

Rapała

et al. 2016

Neurologia i Neurochirurgia Polska

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“…Pathologic findings of miliary BCG yield granulomas that are often negative for acid-fast bacteria, thus supporting the theory of a systemic BCG induced hypersensitivity reaction. Moreover, blood, sputum, and bronchoalveolar lavage cultures are frequently negative for mycobacteria 5 . Mass-like consolidations in the lungs are a rare presentation of pulmonary complications from intravesical BCG.…”

Section: Discussionmentioning

confidence: 99%

Case Presentation: Lung Consolidation as Sequelae of BCG Sepsis After Combined Intravesical and Intraurethral BCG

Strich

Brancato

Dolan

et al. 2017

Urology Case Reports

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“…Regional urological complications can occur as mycobacterium orchi-epidydimitis, prostatis or cystitis. BCG sepsis is a rare (less than 1%, probably due to his high molecular weight) and severe complications with possible multiorgan failure are exceptional [6][7][8][9]. Ectopic localizations are also mentioned: hepatitis, pleural abscess or pneumonitis, spondylodiscitis, arthritis, mycotic aneurysms, chorioretinitis and retroperitoneal abscess.…”

Section: Discussionmentioning

confidence: 99%

Late and Reversible Kidney-Lung Failure after Intra-Bladder BCG Therapy

Mat¹,

Kada²,

Philippart³

et al. 2013

OJNeph

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We observed a 76-year-old man who presented "acute kidney-lung failure" 9 months after intravesical Bacillus Calmette-Guérin (BCG) adjuvant treatment for a T1 bladder cancer. He had inflammatory infiltration on chest radiography and required dialysis for acute renal failure. A percutaneous renal biopsy was performed and revealed tubulointerstitial nephritis with a moderate eosinophilic infiltrate without granulomatous lesion. After a few days, an open lung biopsy was also done due to respiratory deterioration. The anatomopathologic specimen demonstrated moderate fibrosis with lympho-neutrophilic infiltration and few aspecific granulomatous lesions without caseous necrosis. Sarcoïdosis was suspected and high dose oral methylprednisolone was started. Three weeks later, Mycobacterium bovis was identified by Polymerase Chain Reaction on open lung biopsy. He responded well to steroids and tuberculostatic tri-therapy. After one month of immunosuppressive treatment, renal function was resolved and hemodialysis could be discontinued. Despite the frequent use of adjuvant BCG immunotherapy, systemic complications such as hepatitis, pneumonitis, spondylodiscitis or multiorgan failure are rare (<1%). Hematogenous dissemination which occurs a few weeks after traumatic instillations is usually suspected but not demonstrated because of absence of mycobacterium in histological specimen. Our case differs from those previously reported by the simultaneous presence of acid-fast bacilli highlighted on lung samples. We discuss the pathophysiology of BCG complications, the use of prophylactic or therapeutic treatment and recommend guidelines to prevent such complications.

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Miliary pulmonary tuberculosis following intravesical BCG therapy: case report and literature review

Cited by 23 publications

References 16 publications

Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder

Case Presentation: Lung Consolidation as Sequelae of BCG Sepsis After Combined Intravesical and Intraurethral BCG

Late and Reversible Kidney-Lung Failure after Intra-Bladder BCG Therapy

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