Miliary pulmonary infection after BCG intravesical instillation: a rare, misdiagnosed and mistreated complication

Infez Med. 2017 Dec 1;25(4):366-370.

Abstract

Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy decreases the progression risk of non-muscle-invasive bladder cancer, but potentially yields a broad spectrum of side effects. We report the case of a 73-year-old man affected by miliary pulmonary BCG infection, whose microbiological diagnosis was probably hindered by empiric fluoroquinolones, focusing on imaging and clinical work-up.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antitubercular Agents / therapeutic use
  • BCG Vaccine / adverse effects*
  • Bronchoalveolar Lavage Fluid / microbiology
  • Carcinoma, Transitional Cell / therapy
  • Delayed Diagnosis
  • Fever of Unknown Origin / microbiology
  • Humans
  • Immunotherapy / adverse effects*
  • Male
  • Mycobacterium bovis / isolation & purification
  • Mycobacterium bovis / pathogenicity*
  • Ofloxacin / therapeutic use
  • Sputum / microbiology
  • Tuberculosis, Miliary / diagnosis
  • Tuberculosis, Miliary / drug therapy
  • Tuberculosis, Miliary / etiology*
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / etiology*
  • Urinary Bladder Neoplasms / therapy

Substances

  • Antitubercular Agents
  • BCG Vaccine
  • Ofloxacin