Joana Alves¹, Angélica Ramos^2,3, Teresa Carvalho², Susana Silva¹, João Tiago Guimarães^2,3,4, António Sarmento¹

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¹ Infectious Diseases Department, Faculty of Medicine, University of Porto, Centro Hospitalar Sao Joao EPE, Porto, Portugal.
² Clinical Pathology Department, Centro Hospitalar Sao Joao EPE, Porto, Portugal.
³ EPI Unit, Institute of Public Health of University of Porto, Porto, Portugal.
⁴ Biochemistry Department, Faculty of Medicine, University of Porto, Porto, Portugal.
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Abstract: 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 tuberculosis complex, using AccuProbe culture identification and then Genotype Mycobacterium MTBC test identified Mycobacterium bovis BCG. The diagnosis is difficult and microbiologic study is usually negative, so high index of suspicion is essential.

Keywords: Bacillus Calmette-Guérin, Intravesical BCG Therapy, BCG Infection, Disseminated M. bovis BCG Infection

Cite this paper: Alves, J. , Ramos, A. , Carvalho, T. , Silva, S. , Guimarães, J. , Sarmento, A. , (2015) BCG Infection after Bladder Cancer Treatment—3 Clinical Case Reports. Advances in Infectious Diseases, 5, 218-221. doi: 10.4236/aid.2015.54027.

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