Systemic Bacillus Calmette-Guérin Infection, ‘BCGitis’, in Patients
Treated by Intravesical Bacillus Calmette-Guérin Therapy for
Bladder Cancer

Steg, A; Leleu, C; Debré, B; Boccon-Gibod, L; Sicard, Didier

doi:10.1159/000471561

Cited by 99 publications

(78 citation statements)

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“…Additionally to antituberculous therapy, some human and animal studies have suggested potentially beneficial effect of corticosteroid use in the treatment of severe cases of disseminated BCG infection [12][13][14][15][16][17]. The mechanism related to this beneficial effect may be related to the possible hypersensitivity reaction developed during BCG treatment [2,12].…”

Section: Discussionmentioning

confidence: 99%

Septic Shock after Intravesical BCG Instillation—A Case Report

Figueiredo¹,

Póvoas²,

Alves³

et al. 2013

AID

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Bacillus Calmette-Guérin (BCG) is a live attenuated form of Mycobacterium bovis, initially used in medicine as a vaccination agent only. The discovery of its antineoplastic effects in bladder cancer has led to the widespread recognition of BCG intravesical instillation as a therapeutic option. Although sepsis following BCG intravesical instillation is rare, it is nonetheless a dreadful and potentially fatal complication. Therapy usually relies on antituberculous therapy and steroids, alongside with intensive care unit admission. The authors report a case of a 67-year-old male patient who developed septic shock with multiple organ dysfunction after intravesical BCG instillation and review the currently available knowledge concerning the risk factors, diagnosis, management and prevention of BCG sepsis.

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Section: Discussionmentioning

confidence: 99%

Septic Shock after Intravesical BCG Instillation—A Case Report

Figueiredo¹,

Póvoas²,

Alves³

et al. 2013

AID

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“…Morales [3] reported a less than 2% incidence of systemic manifestations requiring isoniazid in a 10-year experience with 82 patients. Steg et al [2] observed a 3% incidence of systemic infection in 169 patients treated with BCG intravesical instilla tions. Fatal septicemia due to disseminated mycobacte rial infection has been exceptionally quoted in this set ting [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Other systemic reactions include pulmonary tuberculosis [1. 3, 6, 7], transient uveitis [6] and hepatic [1,3,8] or bone marrow granuloma [2].…”

Section: Discussionmentioning

confidence: 99%

“…Granuloma is sometimes considered as a delayed hypersensitivity reaction to various antigens, here to mycobacterial proteins [ 12], and occurs rapidly in rats injected with complexed BCG in the presence of an antibody excess [13]. There is evidence in man that BCG and various microorganisms may reach the kidney and other viscera via a hematogenous route [2,9], Sys temic reactions, including renal granuloma, often follow traumatic urethral catheterization with bleeding [2], as was observed in 2 of our patients. Tissue and urine cul tures for tuberculosis are usually negative, but Mycobac terium bovis could be once cultured from a liver biopsy specimen [14].…”

Section: Discussionmentioning

confidence: 99%

“…Intravesical bacillus Calmette-Guérin (BCG) is largely used in the treatment of superficial bladder can cer [ 1,2], Although symptoms of bladder irritability and a flu-like syndrome are common after BCG therapy, severe systemic reactions with renal involvement are rare [ 1 ]. We report the cases of 3 patients who developed progressive renal insufficiency or acute nephritic syn drome after several courses of intravesical instillation with a Pasteur strain of BCG.…”

Section: Introductionmentioning

confidence: 99%

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Renal Complications of Intravesical Bacillus Calmette-Guérin Therapy

Modesto¹,

Marty²,

Suc

et al. 1991

Am J Nephrol

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We report 3 patients who developed signs of systemic infection and renal insufficiency after intravesical bacillus Calmette-Guérin (BCG) instillations for a bladder cancer. Renal biopsy showed tubulo-interstitial nephritis with or without epithelioid granulomas in 2 cases, and mesangial glomerulonephritis in the last case. All patients had granulomatous hepatitis in association. It seems that hematogenous dissemination via a traumatic instillation of BCG and/or an immune-complex mechanism may have contributed to the renal damage, which was only partially reversible in 2 patients.

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Pulmonary granulomata. A complication of intravesical administration of bacillus calmette-guerin for superficial bladder carcinoma

Smith¹,

Alexander²,

Aranda³

1993

Cancer

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Intravesical administration of bacillus Calmette‐Guerin (BCG) is an effective treatment for superficial carcinoma of the bladder. The authors report a pulmonary complication characterized by miliary infiltration on chest roentgenogram and caseating granulomata on lung biopsy specimens. This case and three prior reports suggest that this complication may be a form of hypersensitivity rather than true BCG infection.

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Systemic Bacillus Calmette-Guérin Infection, ‘BCGitis’, in Patients Treated by Intravesical Bacillus Calmette-Guérin Therapy for Bladder Cancer

Cited by 99 publications

References 1 publication

Septic Shock after Intravesical BCG Instillation—A Case Report

Septic Shock after Intravesical BCG Instillation—A Case Report

Renal Complications of Intravesical Bacillus Calmette-Guérin Therapy

Pulmonary granulomata. A complication of intravesical administration of bacillus calmette-guerin for superficial bladder carcinoma

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Systemic Bacillus Calmette-Guérin Infection, ‘BCGitis’, in Patients Treated by Intravesical Bacillus Calmette-Guérin Therapy for Bladder Cancer

Cited by 99 publications

References 1 publication

Septic Shock after Intravesical BCG Instillation—A Case Report

Septic Shock after Intravesical BCG Instillation—A Case Report

Renal Complications of Intravesical Bacillus Calmette-Gu&eacute;rin Therapy

Pulmonary granulomata. A complication of intravesical administration of bacillus calmette-guerin for superficial bladder carcinoma

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Renal Complications of Intravesical Bacillus Calmette-Guérin Therapy