Complications of Intravesical Bacillus Calmette-Guérin

Macleod, Liam C.; Ngo, Tin C.; Gonzalgo, Mark L.

doi:10.5489/cuaj.1411

Cited by 34 publications

(38 citation statements)

References 47 publications

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“…It has been recorded for over 30 years and is now well‐recognized by pathologists. BCG granulomatous prostatitis has been documented in prostate biopsy specimens and in cytological aspirates, but there have been only a few brief accounts relating to cystoprostatectomy specimens . To our knowledge, this is the first systematic study of BCG prostatitis using whole‐mount sections.…”

Section: Discussionmentioning

confidence: 96%

“…The instillation of BCG into the bladder for the management of non‐muscle‐invasive urothelial carcinoma may be followed by local and systemic complications, including granulomatous prostatitis and prostatic abscess …”

Section: Discussionmentioning

confidence: 99%

“…Instillation of Bacillus Calmette‐Guérin (BCG) into the bladder in the management of non‐muscle‐invasive urothelial carcinoma may be followed by various local and systemic complications, including granulomatous prostatitis and prostatic abscess . BCG granulomas have been well‐documented in prostate biopsy specimens and in cytological aspirates, but accounts relating to cystoprostatectomy specimens are relatively sparse …”

Section: Introductionmentioning

confidence: 99%

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The distribution of BCG prostatitis: A clue for pathogenetic processes?

Butel

Ball

2018

The Prostate

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Our observations imply the microanatomical arrangement of prostatic ducts is a factor in the pathogenesis of BCG prostatitis. PZ ducts enter the urethra at less obtuse angles than those from other zones and are likely to be more prone to urine reflux and damage from suspended BCG. We speculate that prostatic duct microanatomy could also play a role in the pathogenesis of other prostatic diseases, including conventional prostatitis and adenocarcinoma.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The distribution of BCG prostatitis: A clue for pathogenetic processes?

Butel

Ball

2018

The Prostate

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“…Disseminated BCG-induced sepsis is a rare but well-documented serious adverse effect of BCG that can occur following either single dose of BCG vaccine or intravesical treatments for bladder cancer. 13 The incidence of disseminated BCG-induced sepsis after BCG vaccination is approximately 0.15-1.56 cases per million of vaccinated children. 14 For intravesical BCG, local side effects including cystitis and prostatitis, typically occur early after treatment, and in up to 20% patients.…”

Section: A S E Pre S Entati Onmentioning

confidence: 99%

DisseminatedMycobacterium bovisinfection post‐kidney transplant following remote intravesicalBCGtherapy for bladder cancer

Ziegler

Gibson

et al. 2018

Transplant Infectious Dis

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Intravesical Bacillus Camlette-Guérin (BCG) is the treatment of choice for non-muscle invasive bladder cancer, and has been used successfully for over 40 years. A rare and potentially fatal complication of intravesical BCG therapy is BCG-induced sepsis. We report a rare case in which a patient with end-stage renal disease secondary to chronic granulomatous interstitial nephritis underwent remote, pre-transplant intravesical BCG treatment for high-grade non-invasive papillary bladder carcinoma. The patient subsequently received a deceased donor kidney transplant 5 years after BCG therapy, with thymoglobulin induction therapy and standard triple maintenance immunosuppression. Two years post-transplant, he developed BCG-induced sepsis confirmed by cultures from urine, blood, and left native kidney biopsy. He died from disseminated BCG-induced sepsis and failure of his renal allograft. This case highlights the potential adverse reactions associated with intravesical BCG therapy that may occur years after bladder cancer therapy is completed, and should heighten physician awareness for BCG-related infections during pre-transplant assessment and post-transplant care of solid organ transplants recipients.

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“…También se presenta con compromiso de sitios que son típicos para la reactivación de la enfermedad por micobacterias, tales como la columna vertebral o el retroperitoneo, la infección de prótesis ortopédicas y endovasculares y endocarditis. Además, se han descrito casos de osteomielitis, artritis infecciosa aguda y aneurismas micóticos (18,(24)(25)(26)(27) . Los mecanismos patogénicos propuestos para el desarrollo de complicaciones después de la instilación de BCG son controversiales (28) .…”

Section: Discusión Y Comentariosunclassified

Impacto de la ley uruguaya de seguridad vial en la mortalidad por siniestros de tránsito

Vanerio

Trostchansky

Machado

et al. 2018

RMU

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La instilación intravesical de bacilo de Calmette-Guérin (BCG) es el tratamiento de primera línea para el carcinoma superficial de células transicionales de la vejiga. Aunque su uso es relativamente seguro, complicaciones graves como hepatitis granulomatosa, osteomielitis, neumonía, sepsis y disfunción orgánica múltiple se producen en algunos pacientes. Presentamos el caso de un paciente con diagnósti-co de carcinoma de células de transición superficial de la vejiga (T1), que fallece como consecuencia de una complicación sistémica grave con severo compromiso del sistema nervioso central, secundaria a la instilación intravesical de BCG. Palabras clave: BACILO DE CALMETTE-GUÉRIN IntroducciónLa resección transuretral puede erradicar completamente determinados tumores de vejiga, aunque la incidencia de recurrencia es relativamente elevada (48% a 70%)(1) . La terapia adyuvante intravesical con una solución de bacilo de Calmette-Guérin (BCG) ha demostrado su efectividad y está incluida en guías de práctica clíni-ca (2,3) . La vacuna contra el BCG, una cepa viva atenuada de Mycobacterium bovis, fue introducida por primera vez en humanos en 1921 (4) . La instilación intravesical de BCG fue descrita por primera vez en 1976 por Morales (5) y se utiliza para el tratamiento del carcinoma de células transicionales superficial de la vejiga. El efecto antitumoral parece ser mediado por inmunidad celular dependiente de los linfocitos T; sin embargo, su modo preciso de acción no es completamente conocido (6) . Esta terapia ha demostrado ser eficaz en retrasar la recurrencia después de la resección transuretral, en reducir el riesgo de progresión a la enfermedad invasiva del músculo, en la erradicación de tumores residuales en algunos pacientes con carcinoma papilar y carcinoma in situ y en mejorar la supervivencia (2,7) . Como contrapartida, puede estar asociada a efectos secundarios importantes. Una complicación poco frecuente pero grave de esta terapia inmunológica es el desarrollo de la enfermedad diseminada por BCG que se puede manifestar por neumonitis, infecciones graves de piel y tejidos blandos, infección genito-urinaria (prostatitis y orqui-1

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Complications of Intravesical Bacillus Calmette-Guérin

Cited by 34 publications

References 47 publications

The distribution of BCG prostatitis: A clue for pathogenetic processes?

The distribution of BCG prostatitis: A clue for pathogenetic processes?

DisseminatedMycobacterium bovisinfection post‐kidney transplant following remote intravesicalBCGtherapy for bladder cancer

Impacto de la ley uruguaya de seguridad vial en la mortalidad por siniestros de tránsito

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