Septic Shock after Intravesical BCG Instillation—A Case Report

Cristóvão Figueiredo, Diana Póvoas, Carlos Alves, Alcina Ferreira, Paulo Figueiredo, Teresa Carvalho, Angélica Ramos, Lurdes Santos, António Sarmento

Infectious Diseases Intensive Care Unit, Research and Development Unit (FCT-725), Faculty of Medicine, University of Porto, Centro Hospitar S?o Jo?o EPE, Porto, Portugal.
Microbiology Laboratory of Clinical Pathology Department, Centro Hospitar S?o Jo?o EPE, Porto, Portugal.

DOI: 10.4236/aid.2013.34036                

Abstract

Bacillus Calmette-Guérin (BCG) is a live attenuated form of Mycobacterium bovis, initially used in medicine as a vaccination agent only. The discovery of its antineoplastic effects in bladder cancer has led to the widespread recognition of BCG intravesical instillation as a therapeutic option. Although sepsis following BCG intravesical instillation is rare, it is nonetheless a dreadful and potentially fatal complication. Therapy usually relies on antituberculous therapy and steroids, alongside with intensive care unit admission. The authors report a case of a 67-year-old male patient who developed septic shock with multiple organ dysfunction after intravesical BCG instillation and review the currently available knowledge concerning the risk factors, diagnosis, management and prevention of BCG sepsis.

 

Keywords

Bacillus Calmette-Guérin; BCG; Sepsis; Shock

Conflicts of Interest

The authors declare no conflicts of interest.

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