Forms of BCG infection among 282 patients with bladder cancer treated with intravesical BCG

Type of complication	Number of patients (%)
Systemic	216 (76.6)
Disseminated BCG infection	97 (34.4)
Persistent fever (as isolated manifestation)	4 (1.4)
Osteomuscular	56 (19.9)
Arthritis	20 (7.1)
Reactive arthritis	16 (5.7)
Spondylodiscitis	10 (3.5)
Prosthetic joint infection	5 (1.8)
Muscle abscess (as isolated manifestation)*	5 (1.8)
Vascular	19 (6.7)
Mycotic aneurysm or pseudoaneurysm^¶	13 (4.6)
Mycotic aneurysm with fistulization	2 (0.7)
Aorto-enteric fistula	2 (0.7)
Infection of vascular bypass graft	2 (0.7)
Ocular (with no articular involvement)	9 (3.2)
Uveitis	7 (2.4)
Endophthalmitis	1 (0.4)
Autoimmune retinopathy	1 (0.4)
Hepatitis (as isolated manifestation)	16 (5.7)
Cutaneous^Δ	4 (1.4)
Pulmonary (other than miliary tuberculosis)	2 (0.7)
Meningitis	1 (0.4)
Other^◊	6 (2.1)
Mixed complications^§	2 (0.7)
Local (genitourinary)	66 (23.4)
Bladder involvement	17 (5.9)
Penile lesions	17 (5.9)
Prostatitis	11 (3.5)
Kidney parenchymal involvement	10 (3.5)
Epididymo-orchitis	10 (3.5)
Pyeloureteral stenosis	1 (0.35)

BCG: Bacillus Calmette-Guerin.
* Overall, 11 patients (3.9%) were diagnosed with muscle abscess: 3 additional cases were secondary to spondylodiscitis; 2 were secondary to mycotic aneurysm or pseudoaneurysm; and 1 was secondary to infection of hip prosthesis.
¶ Overall, 16 patients (5.7%) were diagnosed with mycotic aneurysm: 1 additional case was secondary to spondylodiscitis.
Δ Includes subcutaneous nodules (2 cases), plaque and abscess (1 case each).
◊ Includes peritoneal tuberculosis (2 cases), parotid gland tuberculosis, enteritis, rhabdomyolysis, and prevesical abscess (1 case each).
§ Includes 1 case of pleuropericardial effusion with arthritis and penile lesion, and 1 case of cold abscess of the chest wall with rash and penile lesion.

From: Pérez-Jacoiste Asín MA, Fernández-Ruiz M, López-Medrano F, et al. Bacillus Calmette-Guérin (BCG) infection following intravesical BCG administration as adjunctive therapy for bladder cancer: incidence, risk factors, and outcome in a single-institution series and review of the literature. Medicine (Baltimore) 2014; 93:236. DOI: 10.1097/MD.0000000000000119. Copyright © 2014. Reproduced with permission from Lippincott Williams & Wilkins. Unauthorized reproduction of this material is prohibited.

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Forms of BCG infection among 282 patients with bladder cancer treated with intravesical BCG