Rare systemic complications of intravesical Bacillus Calmette-Guérin therapy
Authors:
Ondřej Tolar 1; Jan Fogl 1; Vít Paldus 1; Vladimír Šámal 1,2
Authors‘ workplace:
Urologie, Krajská nemocnice Liberec, a. s.
1; Urologická klinika LF UK a FN Hradec Králové
2
Published in:
Ces Urol 2026; 30(2): 84-87
Category:
Case report
doi:
https://doi.org/10.48095/cccu2026010
Overview
At the Krajská nemocnice Liberec, intravesical Bacillus Calmette-Guérin (BCG) immunotherapy was administered to approximately 140 patients between 2019 and 2025. We present two case reports – a patient with miliary pulmonary tuberculosis and a patient with a tuberculous abscess located beneath the pectoral muscle following intravesical BCG therapy. Both cases illustrate the importance of early recognition of complications, timely initiation of appropriate antituberculous treatment, and the necessity of a multidisciplinary approach.
Keywords:
intravesical BCG therapy – complications – BCGitis – bladder cancer – case report
Sources
1. Lamm DL, Stogdill VD, Stogdill BJ et al. Complications of bacillus Calmette-Guérin immunotherapy in 1,278 patients with bladder cancer. J Urol 1986; 135(2):272-4. doi: 10.1016/s0022-5347(17)45606-0.
2. World Health Organization. WHO consolidated operational handbook on tuberculosis: module 4: treatment and care. [online]. Available from:
https://www.who.int/publications/i/item/9789240107243.
3. Loued L, Fahem N, Kaddoussi R et al. Miliary tuberculosis following intravesical Bacillus Calmette and Guérin therapy: a rare complication of a frequent procedure. Urol Case Rep 2021; 38 : 101655. doi: 10.1016/j.eucr.2021.101655.
4. European Association of Urology. EAU Guidelines 2025. Non-muscle-invasive bladder cancer (TaT1 and CIS). [online]. Available from: https: //uroweb.org/guidelines/non-muscle-invasive-bladder-cancer.
5. Palou J, Angerri O, Segarra J et al. Intravesical Bacillus Calmette-Guèrin for the treatment of superficial bladder cancer in renal transplant patients. Transplantation 2003; 76(10): 1514–1516. doi: 10.1097/01.TP.0000090748.32764.0F.
6. Yossepowitch O, Eggener SE, Bochner BH et al. Safety and efficacy of intravesical bacillus Calmette-Guerin instillations in steroid treated and immunocompromised patients. J Urol 2006; 176(2): 482–485. doi: 10.1016/j.juro.2006.03.066.
7. Soukup V et al. Prognóza pacientů s T1G3 uroteliálním karcinomem močového měchýře léčených vakcínou BCG – retrospektivní analýza. Ces Urol 2012; 16(4): 230–240. doi: 10.48095/cccu2012038.
8. Sylvester RJ, van der MEIJDEN AP, Lamm DL. Intravesical Bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 2002; 168(5): 1964–1970. doi: 10.1016/S0022-5347(05)64273-5.
9. Kitamura H, Tsukamoto T, Kakehi Y et al. Active surveillance versus intravesical Bacillus Calmette-Guérin for high-grade t1 bladder cancer with negative second transurethral resection: the randomized noninferiority phase 3 JCOG1019 trial. Eur Urol 2026; 89(5): 437–445. doi: 10.1016/j.eururo.2026.01.008.
10. Patel SH, Gabrielson AT, Chan S et al. A phase 2 trial of intravesical gemcitabine and docetaxel in the treatment of Bacillus Calmette-Guérin – naïve nonmuscle-invasive urothelial carcinoma of the bladder. J Urol 2024; 212(1): 95–103. doi: 10.1097/JU.0000000000003977.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2026 Issue 2
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