There is no consensus about the best treatment for lymphadenitis. From to , children were born in Vila Nova Gaia, of which received BCG vaccine and 4 cases of BCGitis occurred in our center — 3 were boys and none had immunity disorders or known family diseases. In all of them, nodal involvement was ipsilateral to BCG administration, without associated symptoms or physical examination abnormalities and happened less than 1 year after vaccination 1—10 months. Figure 1.
|Published (Last):||2 July 2016|
|PDF File Size:||2.24 Mb|
|ePub File Size:||13.66 Mb|
|Price:||Free* [*Free Regsitration Required]|
This is an open-access article distributed under the terms of the Creative Commons Attribution License DEAR EDITOR: In most cases, bladder carcinoma is located superficially, and the therapeutic approach is usually transurethral resection followed by intravesical therapy chemotherapy or immunotherapy. The most common side effects are local inflammation, fever, and pelvic adenopathy.
However, although rare, systemic complications have been described. It is more common in individuals with underlying primary or secondary immunodeficiency but can occur in immunocompetent patients. In March of , a year-old male presented with hematuria. The patient also had hypertension, dyslipidemia, cerebrovascular disease previous stroke , chronic renal failure, and depression. He was being treated with perindopril, indapamide, atorvastatin, acetylsalicylic acid, furosemide, and escitalopram.
He had no known drug allergies. Ultrasound revealed a 2. The patient underwent transurethral resection of the bladder tumor. Histological examination revealed urothelial cell carcinoma grade 2 , without vascular or muscle invasion.
Chemotherapy and immunotherapy with intravesical instillation of BCG were started and continued until December of In February of , the patient presented to the emergency department with a one-week history of dyspnea and productive cough mucopurulent sputum. He reported no fever, chest pain, hemoptysis, sweating, or other symptoms. Auscultation revealed bilateral breath sounds, with crackles in both lung bases. There were no other significant changes.
In addition, a chest X-ray showed bilateral diffuse reticulonodular infiltrates. A CT scan of the chest revealed randomly distributed micronodules in the lungs, together with enlargement of the hilar and mediastinal lymph nodes Figure 1.
After having collected sputum for analysis, we started empirical antibiotic treatment with amoxicillin and clavulanic acid. Due to respiratory failure and suspected miliary tuberculosis or diffuse pulmonary metastasis, the patient was admitted to the respiratory ward of the hospital.
[BCGitis/BCGosis in children: Diagnosis, classification and exploration].
For the patients with abnormal immunological functions, Sanger sequencing was used to identify the involved genes. Classified by infected tissues and organs, no cases only had local infection, 39 patients had a regional infection, 21 patients had a distant infection and 14 patients had a disseminated infection. Thirty-two patients This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist.
BCGitis: A rare complication after intravesical BCG therapy
Arch Pediatr. Epub Jun 2. Electronic address: profbousfiha gmail. This is a live vaccine that protects against severe tuberculosis in children. However, BCG complications, specific to the BCG vaccine, do occur, although the epidemiology differs from one country to another. Nevertheless, these complications are considered to be rare and range from benign local BCGitis to BCGosis, a potentially lethal disseminated disease. Indeed, it is well established that some immunodeficiencies, primary or acquired, can expose the patient to BCG disease.
Bacillus Calmette-Guerin (BCG): intravesikale Therapie des Harnblasenkarzinoms