Immunotherapy with
Bacillus Calmette-Guérin (BCG) to treat non-muscle invasive bladder cancer has
become an effective and superior alternative to chemotherapy. Intravesical
treatment with BCG appears to be relatively safe; however, occasionally BCG
infection complicates such treatment. In the present work we describe three
patients in whom BCG infection occurred after intravesical BCG therapy. All
patients had positive urine culture forMycobacterium tuberculosiscomplex, using AccuProbe culture
identification and then Genotype Mycobacterium MTBC test identifiedMycobacterium bovisBCG. The diagnosis is difficult
and microbiologic study is usually negative, so high index of suspicion is
essential.
References
[1]
Babjuk, M., Bohle, A., Burger, M., Compérat, E., Kaasinen, E., Palou, J., Rouprêt, M., vanRhijn, B.W.G., Shariat, S., Sylvester, R. and Zigeuner, R. (2015) Guidelines on Non-Muscle-Invasive Bladder Cancer (Ta, T1 and CIS). European Association of Urology.
[2]
Lamm, D.L. (1992) Complications of Bacillus Calmette-Guérin Immunotherapy. Urologic Clinics of North America, 19, 565-572.
[3]
Kubica, G.P., Dye, W.E., Cohn, M.L. and Middlebrook, G. (1963) Sputum Digestion and Decontamination with N-Acetyl-L-Cystein Sodium Hydroxide for Culture of Mycobacteria. American Review Respiratory Disease, 87, 775-779.
[4]
Morales, A., Eidenger, D. and Bruce, A.W. (1992) Intracavitary Bacillus Calmette Guerin in the Treatment of Superficial Bladder Tumors. Journal of Urology, 116, 180-183.
[5]
Lamm, D.L., van der Meijden, P.M., Morales, A., Brosman, S.A., Catalona, W.J., Herr, H.W., Soloway, M.S., Steg, A. and Debruyne, F.M. (1992) Incidence and Treatment of Complications of Bacillus Calmette-Guérin Intravesical Therapy in Superficial Bladder Cancer. Journal of Urology, 147, 596-600.
[6]
Asín, M.A.P.-J., Fernández-Ruiz, M., López-Medrano, F., Lumbreras, C., Tejido, á., Juan, R.S., Arrebola-Pajares, A., Lizasoain, M., Prieto, S. and Aguado, J.M. (2014) Bacillus Calmette-Guérin (BCG) Infection Following Intravesical BCG Administration as Adjunctive Therapy for Bladder Cancer. Medicine Jornal, 93, 236-254.
[7]
Tuncer, S., Tekin, M.I., Ozen, H., Bilen, C., Unal, S. and Remzi, D. (1997) Detection of Bacillus Calmette-Guerin in the Blood by the Polymerase Chain Reaction Method of Treated Bladder Cancer Patients. Journal of Urology, 158, 2109-2112. http://dx.doi.org/10.1016/S0022-5347(01)68169-2
[8]
Siatelis, A., Houhoula, D.P., Papaparaskevas, J., Delakas, D. and Tsakris, A. (2011) Detection of Bacillus Calmette-Guerin (Mycobacterium bovis BCG) DNA in Urine and Blood Specimens after Intravesical Immunotherapy for Bladder Carcinoma. Journal Clinical Microbiology, 49, 1206-1208. http://dx.doi.org/10.1128/JCM.01595-10
