Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer

Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Katarzyna Lewandowska [verfasserIn] Anna Lewandowska [verfasserIn] Inga Baranska [verfasserIn] Magdalena Klatt [verfasserIn] Ewa Augustynowicz-Kopec [verfasserIn] Witold Tomkowski [verfasserIn] Monika Szturmowicz [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	bacillus Calmette-Guerin bladder cancer immunotherapy BCGosis BCG pulmonary infection severe respiratory insufficiency

Übergeordnetes Werk:	In: Diagnostics - MDPI AG, 2012, 12(2022), 4, p 922
Übergeordnetes Werk:	volume:12 ; year:2022 ; number:4, p 922

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/diagnostics12040922

Katalog-ID:	DOAJ085300179

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allfieldsGer	10.3390/diagnostics12040922 doi (DE-627)DOAJ085300179 (DE-599)DOAJ988fc50e81924625877924613f03b122 DE-627 ger DE-627 rakwb eng R5-920 Katarzyna Lewandowska verfasserin aut Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations for three years, who was admitted to our hospital due to fever, hemoptysis, pleuritic chest pain and progressive dyspnea. Chest computed tomography (CT) showed massive bilateral ground glass opacities, partly consolidated, localized in the middle and lower parts of the lungs, bronchial walls thickening, and bilateral hilar lymphadenopathy. PCR tests for SARS-CoV-2 as well as sputum, blood, and urine for general bacteriology—were negative. Initial empiric antibiotic therapy was ineffective and respiratory failure progressed. After a few weeks, a culture of <i<M. tuberculosis</i< complex was obtained from the patient’s specimens; the cultured strain was identified as <i<Mycobacterium bovis</i< BCG. Anti-tuberculous treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB) was implemented together with systemic corticosteroids, resulting in the quick improvement of the patient’s clinical condition. Due to hepatotoxicity and finally reported resistance of the BCG strain to INH, levofloxacin was used instead of INH with good tolerance. Follow-up CT scans showed partial resolution of the pulmonary infiltrates. BCG infection in the lungs must be taken into consideration in every patient treated with intra-vesical BCG instillations and symptoms of protracted infection. bacillus Calmette-Guerin bladder cancer immunotherapy BCGosis BCG pulmonary infection severe respiratory insufficiency Medicine (General) Anna Lewandowska verfasserin aut Inga Baranska verfasserin aut Magdalena Klatt verfasserin aut Ewa Augustynowicz-Kopec verfasserin aut Witold Tomkowski verfasserin aut Monika Szturmowicz verfasserin aut In Diagnostics MDPI AG, 2012 12(2022), 4, p 922 (DE-627)718627814 (DE-600)2662336-5 20754418 nnns volume:12 year:2022 number:4, p 922 https://doi.org/10.3390/diagnostics12040922 kostenfrei https://doaj.org/article/988fc50e81924625877924613f03b122 kostenfrei https://www.mdpi.com/2075-4418/12/4/922 kostenfrei https://doaj.org/toc/2075-4418 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 4, p 922
allfieldsSound	10.3390/diagnostics12040922 doi (DE-627)DOAJ085300179 (DE-599)DOAJ988fc50e81924625877924613f03b122 DE-627 ger DE-627 rakwb eng R5-920 Katarzyna Lewandowska verfasserin aut Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations for three years, who was admitted to our hospital due to fever, hemoptysis, pleuritic chest pain and progressive dyspnea. Chest computed tomography (CT) showed massive bilateral ground glass opacities, partly consolidated, localized in the middle and lower parts of the lungs, bronchial walls thickening, and bilateral hilar lymphadenopathy. PCR tests for SARS-CoV-2 as well as sputum, blood, and urine for general bacteriology—were negative. Initial empiric antibiotic therapy was ineffective and respiratory failure progressed. After a few weeks, a culture of <i<M. tuberculosis</i< complex was obtained from the patient’s specimens; the cultured strain was identified as <i<Mycobacterium bovis</i< BCG. Anti-tuberculous treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB) was implemented together with systemic corticosteroids, resulting in the quick improvement of the patient’s clinical condition. Due to hepatotoxicity and finally reported resistance of the BCG strain to INH, levofloxacin was used instead of INH with good tolerance. Follow-up CT scans showed partial resolution of the pulmonary infiltrates. BCG infection in the lungs must be taken into consideration in every patient treated with intra-vesical BCG instillations and symptoms of protracted infection. bacillus Calmette-Guerin bladder cancer immunotherapy BCGosis BCG pulmonary infection severe respiratory insufficiency Medicine (General) Anna Lewandowska verfasserin aut Inga Baranska verfasserin aut Magdalena Klatt verfasserin aut Ewa Augustynowicz-Kopec verfasserin aut Witold Tomkowski verfasserin aut Monika Szturmowicz verfasserin aut In Diagnostics MDPI AG, 2012 12(2022), 4, p 922 (DE-627)718627814 (DE-600)2662336-5 20754418 nnns volume:12 year:2022 number:4, p 922 https://doi.org/10.3390/diagnostics12040922 kostenfrei https://doaj.org/article/988fc50e81924625877924613f03b122 kostenfrei https://www.mdpi.com/2075-4418/12/4/922 kostenfrei https://doaj.org/toc/2075-4418 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 4, p 922
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callnumber-first	R - Medicine
author	Katarzyna Lewandowska
spellingShingle	Katarzyna Lewandowska misc R5-920 misc bacillus Calmette-Guerin misc bladder cancer immunotherapy misc BCGosis misc BCG pulmonary infection misc severe respiratory insufficiency misc Medicine (General) Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer
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topic_title	R5-920 Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer bacillus Calmette-Guerin bladder cancer immunotherapy BCGosis BCG pulmonary infection severe respiratory insufficiency
topic	misc R5-920 misc bacillus Calmette-Guerin misc bladder cancer immunotherapy misc BCGosis misc BCG pulmonary infection misc severe respiratory insufficiency misc Medicine (General)
topic_unstemmed	misc R5-920 misc bacillus Calmette-Guerin misc bladder cancer immunotherapy misc BCGosis misc BCG pulmonary infection misc severe respiratory insufficiency misc Medicine (General)
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title	Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer
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title_full	Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer
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title_sort	severe respiratory failure due to pulmonary bcgosis in a patient treated for superficial bladder cancer
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title_auth	Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer
abstract	Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations for three years, who was admitted to our hospital due to fever, hemoptysis, pleuritic chest pain and progressive dyspnea. Chest computed tomography (CT) showed massive bilateral ground glass opacities, partly consolidated, localized in the middle and lower parts of the lungs, bronchial walls thickening, and bilateral hilar lymphadenopathy. PCR tests for SARS-CoV-2 as well as sputum, blood, and urine for general bacteriology—were negative. Initial empiric antibiotic therapy was ineffective and respiratory failure progressed. After a few weeks, a culture of <i<M. tuberculosis</i< complex was obtained from the patient’s specimens; the cultured strain was identified as <i<Mycobacterium bovis</i< BCG. Anti-tuberculous treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB) was implemented together with systemic corticosteroids, resulting in the quick improvement of the patient’s clinical condition. Due to hepatotoxicity and finally reported resistance of the BCG strain to INH, levofloxacin was used instead of INH with good tolerance. Follow-up CT scans showed partial resolution of the pulmonary infiltrates. BCG infection in the lungs must be taken into consideration in every patient treated with intra-vesical BCG instillations and symptoms of protracted infection.
abstractGer	Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations for three years, who was admitted to our hospital due to fever, hemoptysis, pleuritic chest pain and progressive dyspnea. Chest computed tomography (CT) showed massive bilateral ground glass opacities, partly consolidated, localized in the middle and lower parts of the lungs, bronchial walls thickening, and bilateral hilar lymphadenopathy. PCR tests for SARS-CoV-2 as well as sputum, blood, and urine for general bacteriology—were negative. Initial empiric antibiotic therapy was ineffective and respiratory failure progressed. After a few weeks, a culture of <i<M. tuberculosis</i< complex was obtained from the patient’s specimens; the cultured strain was identified as <i<Mycobacterium bovis</i< BCG. Anti-tuberculous treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB) was implemented together with systemic corticosteroids, resulting in the quick improvement of the patient’s clinical condition. Due to hepatotoxicity and finally reported resistance of the BCG strain to INH, levofloxacin was used instead of INH with good tolerance. Follow-up CT scans showed partial resolution of the pulmonary infiltrates. BCG infection in the lungs must be taken into consideration in every patient treated with intra-vesical BCG instillations and symptoms of protracted infection.
abstract_unstemmed	Intra-vesical instillations with bacillus Calmette-Guerin (BCG) are the established adjuvant therapy for superficial bladder cancer. Although generally safe and well tolerated, they may cause a range of different, local, and systemic complications. We present a patient treated with BCG instillations for three years, who was admitted to our hospital due to fever, hemoptysis, pleuritic chest pain and progressive dyspnea. Chest computed tomography (CT) showed massive bilateral ground glass opacities, partly consolidated, localized in the middle and lower parts of the lungs, bronchial walls thickening, and bilateral hilar lymphadenopathy. PCR tests for SARS-CoV-2 as well as sputum, blood, and urine for general bacteriology—were negative. Initial empiric antibiotic therapy was ineffective and respiratory failure progressed. After a few weeks, a culture of <i<M. tuberculosis</i< complex was obtained from the patient’s specimens; the cultured strain was identified as <i<Mycobacterium bovis</i< BCG. Anti-tuberculous treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB) was implemented together with systemic corticosteroids, resulting in the quick improvement of the patient’s clinical condition. Due to hepatotoxicity and finally reported resistance of the BCG strain to INH, levofloxacin was used instead of INH with good tolerance. Follow-up CT scans showed partial resolution of the pulmonary infiltrates. BCG infection in the lungs must be taken into consideration in every patient treated with intra-vesical BCG instillations and symptoms of protracted infection.
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title_short	Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer
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Severe Respiratory Failure Due to Pulmonary BCGosis in a Patient Treated for Superficial Bladder Cancer

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