CASE REPORT
Tuberculous cervical lymphadenitis after BCG immunotherapy for bladder cancer A case report and review of the literature
 
More details
Hide details
1
Respiratory Failure Unit, Aristotle University of Thessaloniki
 
2
Pulmonary Department, Medical School, Aristotle University of Thessaloniki
 
3
Internal Medicine Department, G. Papanikolaou Hospital, Thessaloniki, Greece
 
4
Radiology Department, G. Papanikolaou Hospital, Thessaloniki, Greece
 
 
Corresponding author
Serafeim-Chrysovalantis Kotoulas   

Serafeim-Chrysovalantis Kotoulas, Resident of Respiratory Medicine, Respiratory Failure Unit, "G. Papanikolaou" General Hospital, Thessaloniki, Greece, 105 Agiou Stefanou street, 57010 Pylaia – Chortiatis, Thessaloniki, Greece
 
 
Pneumon 2020;33(3):143-147
 
KEYWORDS
ABSTRACT
Since its introduction in 1976, Bacille Calmette-Guerin (BCG) has become the standard of care in high risk non-muscle-invasive bladder cancer. Apart from its efficacy, BCG immunotherapy is also considered to be safe. However, in addition to its common adverse effects, which are mild, it can rarely cause serious adverse effects, which can be life threatening.In this report, the case of an 85-year old male, who developed tuberculous cervical lymphadenitis and abscess after BCG immunotherapy is described.The patient presented with acute renal failure. During his hospitalization he also developed hepatitis because of the anti-tuberculous therapy and eventually passed away, probably by septic emboli originated from his right jugular vein which was infiltrated by his abscess.Tuberculous cervical lymphadenitis accompanied with abscess is a quite rare complication of BCG immunotherapy, but clinicians should be aware of it, as it can be proved fatal.
ABBREVIATIONS
BCG: Bacillus Calmette-Guérin, CT: computed tomography
ACKNOWLEDGEMENTS
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
CONFLICTS OF INTEREST
None
FUNDING
This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.
 
REFERENCES (20)
1.
Paterson DL, Patel A. Bacillus Calmette-Guerin (BCG) immunotherapy for bladder cancer: review of complications and their treatment. Aust N Z J Surg 1998; 68:340-4.
 
2.
Newman JR, Clough LA, Merino F. Mycobacterium bovis osteomyelitis of the thoracic spine mimicking a metastatic lytic lesion in a patient exposed to Intravesicular Bacille Calmette-Guérin treatment. Urol Case Rep 2014; 2:142–4.
 
3.
Xie J, Codd C, Mo K, He Y. Differential Adverse Event Profiles Associated with BCG as a Preventive Tuberculosis Vaccine or Therapeutic Bladder Cancer Vaccine Identified by Comparative Ontology-Based VAERS and Literature Meta-Analysis. PLoS One 2016; 11:e0164792.
 
4.
Geldmacher H, Taube C, Markert U, Kirsten DK. Nearly fatal complications of cervical lymphadenitis following BCG immunotherapy for superficial bladder cancer. Respiration 2001; 68:420-1.
 
5.
Rogoziński P, Taracha-Guz D, Pęcikiewicz P, et al. Granulomatous pneumonia as a complication of intravesical BCG immunotherapy—a case report. Pneumonol Alergol Pol 2014; 82:163-9.
 
6.
Kusakabe T, Endo K, Nakamura I, et al. Bacille Calmette-Guérin (BCG) spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy: a case report and literature review. BMC Infect Dis 2018; 18:290.
 
7.
Lara-Oya A, Ramírez-Taboada J, Arenas-Miras Mdel M, RodríguezGranger J. Spondilodyscitis with medullary and spinal abscess caused by Bacillus Calmette-Guérin (BCG). Rev Chilena Infectol 2015; 32:706-9.
 
8.
Ishizu K, Hirata H, Yano S, et al. Tuberculous epididymitis caused by intravesical BCG therapy: a case report. Hinyokika Kiyo 2003; 49:539-42.
 
9.
Díaz C, Baldó C, Martín A, et al. Parotid tuberculosis following intravesical BCG instillation: a case report. Acta Otorrinolaringol Esp 2003; 54:129-33.
 
10.
Arrese M, Ebel L, Hofmann E, et al. Miliary tuberculosis as a complication of BCG immunotherapy in cancer of the bladder.Case report. Rev Med Chil 1992; 120:910-3.
 
11.
Samadian S, Phillips FM, Deeab D. Mycobacterium bovis vertebral osteomyelitis and discitis with adjacent mycotic abdominal aortic aneurysm caused by intravesical BCG therapy: a case report in an elderly gentleman. Age Ageing 2013; 42:129–31.
 
12.
Dogan D, Zor M, Ozkisa T, Ayten O, Yigit N, Yavas I. Mediastinal granulomatous lymphadenitis after intravesical bacillus Calmette-Guerin treatment mimicking distant metastasis of primary bladder carcinoma. Arch Bronconeumol 2015; 51:526-7.
 
13.
Coddington ND, Sandberg JK, Yang C, Sehn JK, Kim EH, Strope SA. Mycotic Aneurysm after Bacillus Calmette-Guérin Treatment: Case Report and Review of the Literature. Case Rep Urol 2017; 2017:4508583.
 
14.
Ye HY, Xu QQ, Huang XB, Ma K, Wang XF. Tuberculous prostatic abscess following intravesical bacillus Calmette-Guerin immunotherapy: a case report. Beijing Da Xue Xue Bao Yi Xue Ban 2015; 47:1039-41.
 
15.
Parker SG, Kommu SS. Post-intravesical BCG epididymo-orchitis: Case report and a review of the literature. Int J Surg Case Rep 2013; 4:768-70.
 
16.
French CG, Hickey L, Bell DG. Caseating granulomas on the glans penis as a complication of bacille calmette-guérin intravesical therapy. Rev Urol 2001; 3:36-8.
 
17.
Pérez-Jacoiste Asín MA, Fernández-Ruiz M, López-Medrano F, et al. Bacillus Calmette-Guérin (BCG) infection following intravesical BCG administration as adjunctive therapy for bladder cancer: incidence, risk factors, and outcome in a single-institution series and review of the literature. Medicine (Baltimore) 2014; 93:236-54.
 
18.
Vu K, Adler H, Gibbons E, Pearson J, Betz W. Intracerebral tuberculomas: A rare cause of seizure in an immunocompetent young male. IDCases 2019; 18:e00599.
 
19.
Moretti M, De Geyter D, Goethal L, Allard SD. Lemierre's syndrome in adulthood, a case report and systematic review. Acta Clin Belg 2020; 29:1-11.
 
20.
Salami A, Assouan C, Garba I, Konan E. An unusual cause of Lemierre Syndrome. J Stomatol Oral Maxillofac Surg 2019; 120:358-60.
 
eISSN:1791-4914
ISSN:1105-848X
Journals System - logo
Scroll to top