Systemic <scp>BCG</scp>‐osis following intravesical <scp>BCG</scp> instillation for bladder carcinoma

Liaw, Frank; Tan, Yan; Hendry, David

doi:10.1002/ccr3.1129

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…Although the evidence of viable organisms in tissue supports the theory of systemic spread and dissemination of Mycobacterium spp. , it has also been postulated that the systemic response is due to a systemic type IV hypersensitivity reaction to BCG [ 42 ]. Diagnosis of disseminated infection is a challenging task due to the diverse array of problems and the lack of evidence from organisms and requires a high index of clinical suspicion on the role of BCG in development of any condition.…”

Section: Systemic Complicationsmentioning

confidence: 99%

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Liu

Huang

et al. 2019

Journal of Oncology

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Because of its proven efficacy, intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is an important treatment for nonmuscle invasive bladder cancer at high risk of recurrence or progression. However, approximately 8% of patients have to stop BCG instillation as a result of its complications. Complications induced by BCG therapy can have a variety of clinical manifestations. These adverse reactions may occur in conjunction with BCG instillation or may not develop until months or years after BCG cessation. An essential step in the management complications arising from BCG is early establishment of diagnosis, particularly for distant, disseminated, and obscure infections. Therefore we reviewed the literature on the potential complications after intravesical BCG immunotherapy for bladder cancer and provide an overview on the incidence, diagnosis, and treatment modality of genitourinary and systemic BCG-induced complications.

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Section: Systemic Complicationsmentioning

confidence: 99%

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Liu

Huang

et al. 2019

Journal of Oncology

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“…It is also reasonable to suspend further courses of intra-vesical BCG therapy. Systemic steroid therapy has shown to be of benefit and should be used in conjunction with antituberculosis therapy followed by gradual tapering [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Disseminated BCG sepsis following intravesical therapy for Bladder Carcinoma: A case report and review of literature

Oladiran

Nwosu

Oladunjoye

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Intravesical instillation of Bacillus-Calmette-Guerin (BCG), a live-attenuated-strain of Mycobacterium bovis , is an established treatment for superficial bladder carcinoma. Although generally well tolerated, 1/15,000 patients can develop life-threatening disseminated-BCG-infection typically soon after the procedure, a condition colloquially termed BCG-osis. Side-effects of intravesical BCG instillation including fever, chills, fatigue are common but BCG-osis is rare and severe, oftentimes requiring intensive care unit admission and triple anti-TB-therapy as in this case. It is therefore important for clinicians to recognize this possibility as the absence of specific signs and symptoms, coupled with the fastidious nature of the Mycobacteria, pose a diagnostic dilemma in the acute setting. Our case highlights this potential rare iatrogenic side effect of intravesical BCG treatment and the risk associated with non-treatment of BCG-osis.

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“…Pyelonephritis and renal abscess are also less common at 0.3%. Systemic complications also occur infrequently at a rate of approximately 3% and include military TB, mycotic aneurysms, granulomatous hepatitis, tuberculous spondylitis, and BCG-related sepsis [6 , 7] .…”

Section: Discussionmentioning

confidence: 99%

Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

Sadeghi

Chaikin

Calhoun

2020

Radiology Case Reports

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Tuberculous epididymo-orchitis is an uncommon complication after intravesical bacilli Calmette-Guerin therapy for nonmuscle invasive bladder cancer. Spread of granulomatous disease through the genitourinary tract specifically to the testes occurs in 0.4% of treated patients. The following case presents a 77-year-old man who underwent intravesical therapy after transurethral resection of bladder tumor and developed testicular discomfort and a palpable mass 2 years after initiation of therapy. After wide range of serum and urine analyses, repeated testicular ultrasonography, and an unsuccessful course of antibiotics, the patient elected to undergo orchiectomy and was confirmed to have tuberculous epididymo-orchitis. Diagnosis based on imaging and laboratory serum and urine analysis may be elusive and therefore review of this entity and associated sonographic findings is discussed.

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Systemic BCG‐osis following intravesical BCG instillation for bladder carcinoma

Cited by 9 publications

References 17 publications

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Disseminated BCG sepsis following intravesical therapy for Bladder Carcinoma: A case report and review of literature

Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

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