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      Spectrum of bacille Calmette-Guérin (BCG) infection after intravesical BCG immunotherapy.

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          Abstract

          Intravesical instillation of bacille Calmette-Guérin (BCG) effectively treats transitional cell carcinoma of the bladder. Occasionally, BCG infection complicates such treatment. In some patients, infection appears early (within 3 months after instillation) and is characterized by generalized symptoms, with pneumonitis and hepatitis. Late-presentation disease occurs >1 year after the first BCG treatment and usually involves focal infection of the genitourinary tract (the site at which bacteria were introduced) and/or other sites that are typical for reactivation of mycobacterial disease, such as the vertebral spine or the retroperitoneal tissues. Noncaseating granulomas are found in the majority of cases, whether early or late. Most patients respond to treatment with antituberculous drugs; in early-presentation disease, when features of hypersensitivity predominate, glucocorticosteroids are sometimes added. Late localized infection often requires surgical resection.

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          Author and article information

          Journal
          Clin Infect Dis
          Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
          University of Chicago Press
          1537-6591
          1058-4838
          Jan 15 2003
          : 36
          : 2
          Affiliations
          [1 ] Department of Medicine, Infectious Disease Section, Baylor College of Medicine, Houston, TX 77030-3498, USA.
          Article
          CID021110
          10.1086/344908
          12522745
          a7e41eb7-2ba1-4fb0-913d-c58f24e5f28d

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