Systemic infection following intravesical therapy with BCG

Area of Science:

• Oncology
• Infectious Diseases
• Immunotherapy

Background:

• Non-muscle-invasive bladder cancer (NMIBC) is commonly treated with Bacillus Calmette-Guérin (BCG) immunotherapy.
• BCG immunotherapy is effective but carries a risk of rare, severe complications.

Observation:

• BCG sepsis is a life-threatening complication that may not be immediately apparent.
• A high index of suspicion is required for early diagnosis of BCG sepsis.

Findings:

• Immediate initiation of anti-bacillary treatment is recommended in suspected cases of BCG sepsis, without awaiting laboratory confirmation.
• Prompt diagnosis and treatment with antituberculosis agents led to full recovery in a severe case.

Implications:

• This case highlights the importance of timely intervention in managing BCG sepsis.
• Early empirical treatment can prevent severe outcomes and improve prognosis in patients with BCG sepsis.