Bacillus Calmette-Guerin (BCG)

Indications

  • Superficial Bladder Cancer (see Bladder Cancer, [[Bladder Cancer]]): intravesical BCG

Pharmacology

  • Bacillus Calmette-Guerin (BCG): an attenuated strain of bovine tuberculous bacterium and consists of living bacilli, dead microorganisms, and subcellular debris

Administration

  • Intravesical: xxx

Adverse Effects

Pulmonary Adverse Effects

Disseminated BCG Infection

Granulomatous Pneumonitis (see Interstitial Lung Disease-Etiology, [[Interstitial Lung Disease-Etiology]])

  • Epidemiology: occurs in <1% of cases
  • Clinical: fever, chills, night sweats, malaise, dyspnea, cough
  • Diagnosis
    • Chest CT: miliary or 2-8 mm nodular pattern (may have mediastinal + hilar lymphadenopathy)
    • FOB-TBB: caseating or non-caseating granulomas

Hypersensitivity Pneumonitis (see Hypersensitivity Pneumonitis, [[Hypersensitivity Pneumonitis]])

  • Diagnosis
    • CXR/Chest CT: interstitial infiltrates
    • FOB-BAL: alveolar lymphocytosis with increased T4/T8 ratio
  • Treatment: favorable response to steroids

Acute Lung Injury (see Acute Lung Injury-ARDS, [[Acute Lung Injury-ARDS]])

  • xx

Other Adverse Effects

  • xxxx

References

  • Granulomatous Pneumonitis Following Intravesical BCG, What Therapy Is Needed? Chest 1994;106:1624-26
  • Granulomatous Chest Disease Following Intravesical Bacillus Calmette-Guerin Immunotherapy. J Thorac Imaging • Volume 19, Number 1, January 2004
  • Hypersensitivity Pneumonitis Following Intravesical Bacille Calmette-Guérin Immunotherapy for Superficial Bladder Cancer. J Investig Allergol Clin Immunol 2009; Vol. 19(3): 230-232