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Case Reports: Unusual association of diseases/symptoms
Papillitis and uveitis complicating Bacillus Calmette-Guérin immunotherapy
  1. Thomas P Toohey1,
  2. Sharon Wallace2,
  3. Michael G Toohey3 and
  4. Ian C Francis4
  1. 1Department of Ophthalmology, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
  2. 2Dorevitch Pathology, Ballarat Health Services, Ballarat Central, Victoria, Australia
  3. 3Department of Surgery, Ballarat Base Hospital, Ballarat Central, Victoria, Australia
  4. 4Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Thomas P Toohey; tomtoohey93{at}gmail.com

Abstract

Intravesical Bacillus Calmette-Guérin (BCG) administration was used to treat bladder carcinoma in a woman in her 60s. Severe bilateral non-granulomatous anterior uveitis and gross papillitis developed subsequently. The severe BCG-induced bilateral uveitis and papillitis were treated with high dose oral corticosteroids, with topical steroids and cycloplegics. Resolution of her ocular symptoms and signs eventuated. On lumbar puncture, no evidence of systemic spread of the BCG was found. Visual acuity returned to 6/9 in each eye with subsequent resolution of papillitis. Repeat cystoscopy demonstrated no evidence of recurrent bladder tumour.

Hypersensitivity reactions are well recognised with Tubercle bacilli. While both hypersensitivity reactions and dissemination of BCG throughout the body have been previously documented, the literature demonstrates that this case is the first example in which papillitis and bilateral uveitis were the prominent ophthalmological features.

  • Iris
  • Visual pathway
  • Urinary and genital tract disorders

https://doi.org/10.1136/bcr-2021-247578

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    Footnotes

    • Contributors TPT, SW, MGT and ICF contributed to the design and implementation of the research, to the analysis of the results, to the writing of the manuscript and the final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.