Disseminated Bacillus Calmette-Guérin (BCG) infection with pulmonary and renal involvement: A rare complication of BCG immunotherapy. A case report and narrative review
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Abstract
<p class="first" id="d2720904e103">Intravesical Bacillus Calmette-Guérin (BCG) instillation
is a mainstay of adjunctive
therapy for superficial bladder cancer that increases length of disease progression-free
survival. Although usually well tolerated, moderate to severe local and systemic infectious
complications can occur with this immunotherapy. Diagnosis is difficult and often
based on high clinical suspicion since in many cases Mycobacterium bovis is not isolated.
Treatment is not fully standardized but the combination of anti-tuberculosis drugs
and corticosteroids is advocated in severe cases. The authors present an unusual case
of a severe infectious complication following intravesical BCG instillation with pulmonary
and kidney involvement. Prompt anti-tuberculosis treatment associated to corticosteroid
resulted in a marked clinical and radiological improvement, supporting the diagnosis
of disseminated BCG infection. Based on this, the authors aimed to review the literature
on this exceptional complication of this immunotherapy.
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