Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome
Objectives: Intravesical Bacillus Calmette-Guérin (BCG) treatment for superficial bladder cancer is interrupted in approximatively 8% of cases as a result of complications. The objective is to report the severe related complications of Bacillus Calmette-Guérin (BCG) following an intravesical instill...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579420300073 |
| _version_ | 1828473022617485312 |
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| author | R. Waked J. Choucair N. Chehata E. Haddad G. Saliba |
| author_facet | R. Waked J. Choucair N. Chehata E. Haddad G. Saliba |
| author_sort | R. Waked |
| collection | DOAJ |
| description | Objectives: Intravesical Bacillus Calmette-Guérin (BCG) treatment for superficial bladder cancer is interrupted in approximatively 8% of cases as a result of complications. The objective is to report the severe related complications of Bacillus Calmette-Guérin (BCG) following an intravesical instillation for bladder tumor encountered at our institution for the past 5 years. Methods: Medical records of a tertiary teaching hospital, located in Beirut, Lebanon, were retrospectively analyzed from June 2014 to June 2019 searching for severe related complications of BCG. A comprehensive review of articles on this subject was conducted. Results: The incidence of severe systemic adverse events related to BCG instillation was 1.5% (5 out of 332 patients). A total of five patients were found to have a severe BCG related complication, with fever, chills, and irritative urinary signs being the most frequent symptoms. All patients received antituberculosis therapy (Isoniazid, Rifampin and Ethambutol). Two were put on add-on corticosteroids. Three patients had a computed tomography scan image in favor of an infection. Two patients had a favorable outcome, three patients died. Conclusion: BCG severe adverse events were mostly seen in patients with a traumatic instillation. Treatment used at our institution was similar to most cases reported in the literature. A standardized diagnostic and treatment approach should be implemented to help physicians tackle these life-threatening complications. |
| first_indexed | 2024-12-11T05:38:14Z |
| format | Article |
| id | doaj.art-92737d143b1c4a3d8b0067747de20005 |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-12-11T05:38:14Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-92737d143b1c4a3d8b0067747de200052022-12-22T01:19:13ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942020-05-0119Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcomeR. Waked0J. Choucair1N. Chehata2E. Haddad3G. Saliba4Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, Lebanon; Corresponding author.Coordinator of the Infectious Diseases department, Saint Joseph University, Beirut, LebanonDepartment of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, LebanonDepartment of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, LebanonDepartment of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, LebanonObjectives: Intravesical Bacillus Calmette-Guérin (BCG) treatment for superficial bladder cancer is interrupted in approximatively 8% of cases as a result of complications. The objective is to report the severe related complications of Bacillus Calmette-Guérin (BCG) following an intravesical instillation for bladder tumor encountered at our institution for the past 5 years. Methods: Medical records of a tertiary teaching hospital, located in Beirut, Lebanon, were retrospectively analyzed from June 2014 to June 2019 searching for severe related complications of BCG. A comprehensive review of articles on this subject was conducted. Results: The incidence of severe systemic adverse events related to BCG instillation was 1.5% (5 out of 332 patients). A total of five patients were found to have a severe BCG related complication, with fever, chills, and irritative urinary signs being the most frequent symptoms. All patients received antituberculosis therapy (Isoniazid, Rifampin and Ethambutol). Two were put on add-on corticosteroids. Three patients had a computed tomography scan image in favor of an infection. Two patients had a favorable outcome, three patients died. Conclusion: BCG severe adverse events were mostly seen in patients with a traumatic instillation. Treatment used at our institution was similar to most cases reported in the literature. A standardized diagnostic and treatment approach should be implemented to help physicians tackle these life-threatening complications.http://www.sciencedirect.com/science/article/pii/S2405579420300073Mycobacterial infectionIntravesical Bacillus Calmette-GuérinBacillus Calmette-GuerinUrothelial bladder cancerSevere complicationTreatment protocol |
| spellingShingle | R. Waked J. Choucair N. Chehata E. Haddad G. Saliba Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Mycobacterial infection Intravesical Bacillus Calmette-Guérin Bacillus Calmette-Guerin Urothelial bladder cancer Severe complication Treatment protocol |
| title | Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome |
| title_full | Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome |
| title_fullStr | Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome |
| title_full_unstemmed | Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome |
| title_short | Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome |
| title_sort | intravesical bacillus calmette guerin bcg treatment s severe complications a single institution review of incidence presentation and treatment outcome |
| topic | Mycobacterial infection Intravesical Bacillus Calmette-Guérin Bacillus Calmette-Guerin Urothelial bladder cancer Severe complication Treatment protocol |
| url | http://www.sciencedirect.com/science/article/pii/S2405579420300073 |
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