Spectrum of bacille Calmette-Guérin (BCG) infection after intravesical BCG immunotherapy

Omar Y. Gonzalez, Daniel M. Musher, Indira Brar, Seth Furgeson, Maha R. Boktour, Edward J. Septimus, Richard J. Hamill, Edward A. Graviss

Research output: Contribution to journalArticlepeer-review

122 Scopus citations

Abstract

Intravesical instillation of bacille Calmette-Guérin (BCG) effectively treats transitional cell carcinoma of the bladder. Occasionally, BCG infection complicates such treatment. In some patients, infection appears early (within 3 months after instillation) and is characterized by generalized symptoms, with pneumonitis and hepatitis. Late-presentation disease occurs >1 year after the first BCG treatment and usually involves focal infection of the genitourinary tract (the site at which bacteria were introduced) and/or other sites that are typical for reactivation of mycobacterial disease, such as the vertebral spine or the retroperitoneal tissues. Noncaseating granulomas are found in the majority of cases, whether early or late. Most patients respond to treatment with antituberculous drugs; in early-presentation disease, when features of hypersensitivity predominate, glucocorticosteroids are sometimes added. Late localized infection often requires surgical resection.

Original languageEnglish (US)
Pages (from-to)140-148
Number of pages9
JournalClinical Infectious Diseases
Volume36
Issue number2
DOIs
StatePublished - Jan 15 2003

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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