Severe Infectious Complications of Intravesical Bacillus Calmette-Guérin: A Case Series of 10 Patients

Courtney Yong; Ryan L Steinberg; Michael A O'Donnell

doi:10.1016/j.urology.2019.10.013

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Severe Infectious Complications of Intravesical Bacillus Calmette-Guérin: A Case Series of 10 Patients

Journal article

Peer reviewed

Severe Infectious Complications of Intravesical Bacillus Calmette-Guérin: A Case Series of 10 Patients

Courtney Yong, Ryan L Steinberg and Michael A O'Donnell

Urology (Ridgewood, N.J.), Vol.137, pp.79-83

03/2020

DOI: 10.1016/j.urology.2019.10.013

PMID: 31705946

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Abstract

To investigate severe infectious complications after intravesical treatment with bacillus Calmette-Guérin (BCG). We examine a retrospective case series of 10 patients between 2006 and 2018 with severe cystitis or systemic infection after BCG. Patients with BCG cystitis or disseminated infection were retrospectively identified between 2006 and 2018 at our institution. Cases were reviewed for bladder cancer treatments, demographics, treatment of infection, and outcomes. There was a 0.8% rate of severe BCG cystitis or disseminated infection. Seven patients experienced delayed-onset infections >3 months after last BCG instillation. Four had isolated bladder symptoms, and 5 had diverse systemic manifestations. One patient was asymptomatic and diagnosed on cystoscopic findings. All were treated with varied antibiotic regimens; 9 included antituberculous therapy, and 1 was treated with levofloxacin alone. Two underwent cystectomy for end-stage bladder. The remaining patients are asymptomatic with no residual effects. All are in remission for bladder cancer. Severe infectious complications after BCG are rare and thus difficult to study. Treatment regimens can vary widely. Thorough reporting of patient outcomes is essential to expand the limited body of knowledge.

Adjuvants, Immunologic - administration & dosage

Adjuvants, Immunologic - adverse effects

Administration, Intravesical

Aged

Anti-Bacterial Agents - administration & dosage

Anti-Bacterial Agents - classification

BCG Vaccine - administration & dosage

BCG Vaccine - adverse effects

Cystectomy - methods

Cystitis - diagnosis

Cystitis - etiology

Cystitis - physiopathology

Cystitis - therapy

Female

Humans

Male

Outcome and Process Assessment, Health Care

Retrospective Studies

Sepsis - diagnosis

Sepsis - etiology

Sepsis - physiopathology

Sepsis - therapy

Severity of Illness Index

Urinary Bladder Neoplasms - therapy

Details

Title: Subtitle: Severe Infectious Complications of Intravesical Bacillus Calmette-Guérin: A Case Series of 10 Patients
Creators: Courtney Yong - University of Iowa
Ryan L Steinberg - The University of Texas Southwestern Medical Center
Michael A O'Donnell - University of Iowa, Department of Urology, Iowa City, IA. Electronic address: michael-odonnell@uiowa.edu
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.137, pp.79-83
DOI: 10.1016/j.urology.2019.10.013
PMID: 31705946
ISSN: 0090-4295
eISSN: 1527-9995
Language: English
Date published: 03/2020
Academic Unit: Urology
Record Identifier: 9984320071302771

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