Mycobacterium bovis (BCG strain): Difference between revisions
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Mycobacterium bovis (BCG strain)
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== Background == |
== Background == |
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* Intravesicular instillation is used to treat bladder cancer |
* Intravesicular instillation of ''Mycobacterium bovis'' BCG strain is sometimes used to treat bladder cancer |
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* It can occasionally cause infections, sometimes referred to as BCGitis |
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== Clinical Manifestations == |
== Clinical Manifestations == |
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** Common symptoms are localized bladder irritation (dysuria, frequency, hematuria), with low-grade fevers and malaise |
** Common symptoms are localized bladder irritation (dysuria, frequency, hematuria), with low-grade fevers and malaise |
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* Systemic spread can cause a sepsis syndrome, pulmonary disease (miliary or interstitial disease), granulomatous hepatitis, osteomyelitis (most commonly the spine), psoas abscess, and (very rarely) vascular complications including arteritis or vasa vasorum or contiguous spread from local infection to the adjacent arteries |
* Systemic spread can cause a sepsis syndrome, pulmonary disease (miliary or interstitial disease), granulomatous hepatitis, osteomyelitis (most commonly the spine), psoas abscess, and (very rarely) vascular complications including arteritis or vasa vasorum or contiguous spread from local infection to the adjacent arteries |
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== Management == |
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* Induction with [[isoniazid]], [[rifampin]], and [[ethambutol]], followed by consolidation with [[isoniazid]] and [[rifampin]] |
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* Sometimes needs surgery |
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[[Category:Mycobacteria]] |
[[Category:Mycobacteria]] |
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Revision as of 17:47, 22 October 2025
Background
- Intravesicular instillation of Mycobacterium bovis BCG strain is sometimes used to treat bladder cancer
- It can occasionally cause infections, sometimes referred to as BCGitis
Clinical Manifestations
- Median time from instillation to onset of symptoms is 169 days1 (range 3 months to many years)
- Disease can disseminate to liver, lungs, bone marrow, bones, joints (in descending order of frequency)
- Localized disease can cause cystitis, bladder contractures, granulomatous prostatitis, prostate abscess, epididymo-orchitis, testicular abscess, pyelonephritis, renal abscess, ureteral stricture, penile granuloma
- Common symptoms are localized bladder irritation (dysuria, frequency, hematuria), with low-grade fevers and malaise
- Systemic spread can cause a sepsis syndrome, pulmonary disease (miliary or interstitial disease), granulomatous hepatitis, osteomyelitis (most commonly the spine), psoas abscess, and (very rarely) vascular complications including arteritis or vasa vasorum or contiguous spread from local infection to the adjacent arteries
Management
- Induction with isoniazid, rifampin, and ethambutol, followed by consolidation with isoniazid and rifampin
- Sometimes needs surgery
References
- ^ Paolo Cabas, Michele Rizzo, Mauro Giuffrè, Roberta Maria Antonello, Carlo Trombetta, Roberto Luzzati, Giovanni Liguori, Stefano Di Bella. BCG infection (BCGitis) following intravesical instillation for bladder cancer and time interval between treatment and presentation: A systematic review. Urologic Oncology: Seminars and Original Investigations. 2021;39(2):85-92. doi:10.1016/j.urolonc.2020.11.037.
