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
- Clinical
- Focal Pneumonia (see Pneumonia, [[Pneumonia]])
- Empyema (see Pleural Effusion-Exudate, [[Pleural Effusion-Exudate]])
- Cavitary Infiltrates (see Cystic-Cavitary Lung Lesions, [[Cystic-Cavitary Lung Lesions]] and Tuberculosis, [[Tuberculosis]]): mimicking TB
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