Summary
Immunotherapy using bacille Calmette-Guérin (BCG) has gained increasing acceptance in the management of superficial bladder cancer. Systemic reactions after intravesical instillation of BCG are rare. However, when the therapy is complicated, the lung often becomes involved. Since the pathogenesis of lung infiltrates after immunotherapy is unknown, we report on a patient who developed a lung infiltrate after receiving BCG immunotherapy for bladder cancer. The infectious etiology was established by culture confirmation of a BCG strain in the broncheoalveolar lavage fluid.
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Abbreviations
- BCG:
-
bacille Calmette-Guérin
References
Aungst CW, Sokal JE, Jaeger BV (1975) Complications of BCG vaccination in neoplastic disease. Ann Intern Med 86:666–668
Böhle A, Gerdes J, Ulmer AJ, Hofstetter AG, Flad HD (1990) Effects of local bacillus Calmette-Guérin therapy in patients with bladder carcinoma on immunocompetent cells of the bladder wall. J Urol 144:53–58
Boisgisson P de, Roussel F, Leclerc D, Picquenot JM (1991) Granulomatous renal mass during endovesical BCG therapy for bladder carcinoma. Urology 37:557–560
Brosman SA (1981) Experience with bacillus Calmette-Guérin in patients with superficial bladder carcinoma. J Urol 128:27–29
Collins FM (1991) Antituberculous immunity. Rev Infect Dis 13:940–950
Deresiewicz RL, Stone RM, Aster JC (1990) Fatal disseminated mycobacterial infection following intravesical bacillus Calmette-Guérin. J Urol 144:1331–1334
Editorial (1991) Topical BCG for recurrent superficial bladder cancer. Lancet 337:821–822
Flippin T, Mukherji B, Dayal Y (1973) Granulomatous hepatitis as a late complication of BCG immunotherapy. Lancet 337:820–821
Gupta RC, Lavengood R, Smith JP (1988) Miliary tuberculosis due to intravesical bacillus Calmette-Guérin therapy. Chest 94:1296–1298
Herr HW, Laudone VP, Whitmore WF (1987) An overview of intravesical therapy for superficial bladder tumors. J Urol 138:1363–1368
Israel-Biet D, Venet A, Sandron D, Ziza JM, Chretien J (1987) Pulmonary complications of intravesical bacille Calmette-Guérin immunotherapy. Am Rev Respir Dis 135:763–765
Kavoussi LR, Brown EJ, Ritchey JK, Ratliff TL (1990) Fibronectin-mediated Calmette-Guérin bacillus attachment to murine bladder mucosa. J Clin Invest 85:62–67
Kesten S, Title L, Mullen B, Grossman R (1990) Pulmonary disease following intravesical BCG treatment. Thorax 45:709–710
Lage JM, Bauer WC, Kelly DR, Ratliff TL, Catalona WJ (1986) Histological parameters and pitfalls in the interpretation of bladder biopsies in bacillus Calmette-Guérin treatment of superficial bladder cancer. J Urol 135:916–919
Lamm DL, Steg A, Boccon-Gibod L (1989) Complications of bacillus Calmette-Guérin immunotherapy: review of 2602 patients and comparison of chemotherapy complications. Prog Clin Biol Res 310:335
Lamm DL, Blumenstein BA, Crawford ED (1991) A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guérin for transitional-cell carcinoma of the bladder. New Engl J Med 325:1205–1206
Leong ASY, Wannakrairot P, Jose J, Milios J (1990) Bacillus Calmette-Guérin-treated superficial bladder cancer. J Path 162:35–41
Lotte A, Wasz-Höckert O, Poisson N (1984) BCG complications. Estimates of the risk among vaccinated subjects and statistical analysis of their main characteristics. Advances in Tuberculosis Research 21:107–110
Marks K, Jenkins PA, Kilpatrick GS, Engbarek HC, Vergmann B (1971) Pulmonary tuberculosis due to BCG. Br Med J 3:229–230
McKahn CF, Hendrickson CG, Spitler LE (1975) Immunotherapy of melanoma with BCG: two fatalities following intralesional injection. Cancer 35:514–520
Morales A, Eidinger D, Bruce AW (1976) Intracavity bacillus Calmette-Guérin in the treatment of superficial bladder tumors. J Urol 116:183–186
Myparland C, Cotton DJ, Gowda KS, Hoepner VH (1992) Miliary Mycobacterium bovis induced by intravesical Bacille Calmette-Guérin immunotherapy. Am Rev Respir Dis 146:1330–1333
Orihuela E, Herr HW, Pinsky CM, Whithmore WF (1987) Toxicity of intravesical BCG and its management in patients with superficial bladder tumors. Cancer 60:326–333
Rawls WH, Lamm DL, Lowe BA (1990) Fatal sepsis following intravesical bacillus Calmette-Guérin administration for bladder cancer. J Urol 144:1328–1330
Ritch PS, McCredic KB, Gutterman JU, Hersh EM (1978) Disseminated BCG disease associated with immunotherapy by scarification in acute leukemia. Cancer 167:167–170
Steg A, Leleu C, Debre B (1989) Systemic bacillus Calmette-Guérin infection in patients treated by intravesical BCG therapy for superficial bladder cancer. Prog Clin Biol Res 310:325–334
Welte T, Hamm H, Fabel H (1992) Generalized infection with bacille Calmette-Guérin (BCG) after intravesical instillation for local treatment of bladder cancer. Eur J Respir [Suppl 15] 5:75s
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Kirsten, D., Rieger, U., Schröder, K.H. et al. Pulmonary tuberculosis due to bacille Calmette-Guérin. Clin Investig 71, 787–790 (1993). https://doi.org/10.1007/BF00190319
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DOI: https://doi.org/10.1007/BF00190319