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Infectious Diseases
BCG-osis: a complication after intravesical BCG immunotherapy
  1. Crisanta Simon1,
  2. Ushani Jeyasinghe2 and
  3. Bethel Shiferaw3
  1. 1Department of Medicine, Saint Marys Hospital Graduate Medical Education, Waterbury, Connecticut, USA
  2. 2Department of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
  3. 3Department of Infectious Diseases, Saint Marys Hospital Graduate Medical Education, Waterbury, Connecticut, USA
  1. Correspondence to Dr Crisanta Simon; crisantasimon{at}hotmail.com

Abstract

BCG, or live attenuated Mycobacterium bovis, intravesical immunotherapy is now an established component of the standard of care for bladder cancer following transurethral resection of bladder tumour. The following case demonstrates the rare complication of disseminated BCG (BCG-osis) that may arise after the aforementioned therapy. Patients at increased risk of this complication include those who are immunocompromised, above the age of 70 and patients who have had traumatic catheterisation. Diagnosis can be made with or without microbiology and management includes a multidrug regimen. It is important to recognise the signs and symptoms of BCG-osis and postpone future intravesical instillation of BCG if there is traumatic catheterisation. Future instillation should be completely discontinued if a patient develops disseminated M. bovis.

  • Cancer intervention
  • Immunological products and vaccines
  • Urinary tract infections
  • TB and other respiratory infections
  • Urological cancer

https://doi.org/10.1136/bcr-2024-261804

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    Footnotes

    • Contributors The following authors were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: CS, UJ and BS. The following author gave final approval of the manuscript: BS.

    • 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.