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Related Experiment Videos

[Multisystem disease caused by BCG imitating miliary tuberculosis].

I Tsikonov1, D Yeshurun, J E Naschitz

  • 1Dept. of Medicine A, Bnai Zion Medical Center, Technion, Haifa.

Harefuah
|July 29, 2000
PubMed
Summary

A 79-year-old man developed a pulmonary tuberculosis-like syndrome after Bacillus Calmette-Guérin (BCG) immunotherapy for bladder cancer. Symptoms resolved with 3-drug antitubercular treatment and steroids, indicating a favorable prognosis for BCG-osis.

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Area of Science:

  • Oncology
  • Immunology
  • Infectious Diseases

Background:

  • Bacillus Calmette-Guérin (BCG) immunotherapy is a standard treatment for non-muscle-invasive bladder cancer.
  • Tuberculosis (TB) prevalence is increasing in Western countries, necessitating awareness of TB-like syndromes.
  • Immunotherapy can sometimes trigger immune responses mimicking infectious diseases.

Observation:

  • A 79-year-old male patient presented with a pulmonary syndrome resembling tuberculosis after receiving BCG for bladder carcinoma.
  • The patient's symptoms included cough and radiographic findings consistent with pulmonary infiltrates.
  • Cultures for Mycobacterium tuberculosis were negative, ruling out active TB infection.

Findings:

  • The patient's condition, termed BCG-osis, responded favorably to a 3-drug antitubercular regimen.

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  • Addition of corticosteroids further aided symptom resolution.
  • BCG-osis demonstrated a more favorable clinical course compared to miliary tuberculosis, even with less intensive treatment.

    • Implications:

    • BCG immunotherapy for bladder cancer can induce a distinct pulmonary syndrome (BCG-osis).
    • Early recognition and appropriate management, including antitubercular drugs and steroids, are crucial for favorable outcomes.
    • Clinicians should consider BCG-osis in patients with pulmonary symptoms post-BCG immunotherapy, especially given rising TB rates.