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Vol. 32. Issue 2.
Pages 100-102 (February 1996)
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Vol. 32. Issue 2.
Pages 100-102 (February 1996)
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Diseminación miliar con afectación pulmonar secundaria a inmunoterapia intravesical con bacilo de Calmette-Guérin
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C. Paredes Arranz*,1, J.F. de Frutos Arribas*, J. Calleja Escudero**, M. Blanco Cabero*, F. del Campo Matías*, M.C. Velasco***
* Sección de Neumología. Hospital del Río Hortega. Valladolid
** Servicio de Urología. Hospital del Río Hortega. Valladolid
*** Servicio de Anatomía Patológica. Hospital del Río Hortega. Valladolid
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Se describe el caso de un varón de 67 años sometido a resección transuretral e inmunoterapia con bacilo de Calmette-Guérin (BCG) por presentar un carcinoma transicional superficial de vejiga. Tras varias sesiones de instilación intravesical del preparado (BCG), el paciente desarrolló un cuadro de fiebre, astenia y anorexia persistente que motivó su ingreso hospitalario. Se realizaron diversas pruebas, estableciéndose el diagnóstico de diseminación miliar por BCG, que evolucionó fatalmente, a pesar del tratamiento tuberculostático.

La administración intravesical de BCG rara vez origina complicaciones graves por diseminación hematógena aunque, actualmente, parece ser más frecuente de lo que se pensaba.

La infección diseminada debe sospecharse en todo paciente que reciba BCG y con un cuadro clínico compatible. El conocimiento de esta complicación y la instauración precoz del tratamiento específico son la única medida que mejorará el pronóstico de esta importante complicación.

Palabras clave:
Inmunoterapia BCG
Diseminación miliar

We describe the case of a 67-years-old man who underwent transurethral resection and immunotherapy with Calmette-Guérin bacillus solution (CGB) for superficial transitional carcinoma of the bladder. After a series of intravesical irrigations with CGB, the patient developed fever, asthenia and persistent anorexia and was hospitalized. After testing he was diagnosed of miliary tuberculosis due to CGB and died in spite of tuberculostatic therapy.

Hematogenous dissemination, a rare but serious complication of vesical irrigation with CGB, is thought to be more common than previously suspected. It should be suspected in all patients receiving CGB when a compatible clinical pieture presents. An understanding of this complication and early establishment of specific treatment is the only wat to improve prognosis.

Key words:
Calmette-Guérin bacillus immunotherapy
Miliary tuberculosis
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
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