Del Castillo Duran Y, Santos Bodí F, Castander Serentill D, Jubert Montaperto P, Espinosa Valencia P, Rabassó Sole C
Unidad de Cuidados Intensivos, Hospital de Sant Pau i Santa Tecla, Tarragona, España.
Med Intensiva. 2006 Apr;30(3):116-9. doi: 10.1016/s0210-5691(06)74485-0.
Tuberculosis miliar is a very rare complication of bacillus Calmette-Guérin (BCG) immunotherapy that is associated to high mortality. Thus, early diagnosis and treatment is essential. At present, there is a polymerase chain reaction technique (PCR) which is a rapid diagnostic method with elevated sensitivity. Treatment with tuberculostatic agents should be initiated as soon as possible, the combination of corticosteroids and cycloserine in serious cases being advisable. A case of a 75 year old patient with intravesical BCG instillations after a transurethral resection of bladder cancer is presented. He was admitted to the Intensive Care Unit (ICU) due to severe acute respiratory failure evolving to acute respiratory distress syndrome (ARDS). Mycobacterium bovis DNA was identified by PCR in blood samples and bronchoaspirate (BAS). He was treated with tuberculostatic agents and corticosteroids, dying due to respiratory failure.
