Miliary BCG–pneumonitis: a rare complication of intravesical BCG therapy
Authors:
Barbora Nechanská 1; Jan Zaplatílek 1; Richard Pabišta 1; Olga Zadražilová 2
Authors‘ workplace:
Urologické oddělení, Oblastní nemocnice Mladá Boleslav, a. s., Mladá Boleslav
1; Plicní oddělení, Oblastní nemocnice Mladá Boleslav, a. s., Mladá Boleslav
2
Published in:
Ces Urol 2019; 23(2): 140-148
Category:
Case report
Overview
Adjuvant intravesical immunotherapy with Bacillus Calmette-Guérin (BCG) vaccine is an effective treatment for patients with high risk non-muscleinvasive bladder carcinoma. The therapy is usually well tolerated and accompanied only by local or mild systemic symptoms (dysuria, mild increase of body temperature). Life-threatening systemic complications (nephritis, pneumonitis, BCG - sepsis) occur rarely. Their diagnostics can be challenging due to non-specific symptoms and frequent negative findings in the urine, sputum or blood culture. A recommended treatment of systemic BCG infection is long-term antimicrobial therapy with chinolones and antituberculotics including the corticosteroids. Current knowledge of complications of intravesical BCG therapy comes mainly from individual case reports. We report a case of the patient with miliary BCG-pneumonitis. The aim of this work is to increase awareness of disseminated disease as a complication of intravesical BCG immunotherapy, discuss the diagnostic methods and emphasise early antitubercular therapy even without the demonstration of viable bacteria or positive cultures.
Keywords:
Bacillus Calmette-Guérin – disseminated pulmonary disease – immunotherapy – Mycobacterium bovis.
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Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2019 Issue 2
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