Case Report
Volume: 5 | Issue: 1 | Published: Jan 20, 2021 | Pages: 18 - 21 | DOI: 10.24911/ejmcr/173-1592252959
Shingles infection resulting from BCG treatment for bladder cancer: a case report
Authors: Vivian Wong , Diana M. Lopategui , Elias Atri , Akshay Bhandari
Article Info
Authors
Vivian Wong
Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
Diana M. Lopategui
Division of Urology, Columbia University Mount Sinai Medical Center, Miami, FL, USA
Elias Atri
Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
Akshay Bhandari
Division of Urology, Columbia University Mount Sinai Medical Center, Miami, FL, USA
Publication History
Received: June 15, 2020
Revised: October 04, 2020
Accepted: October 04, 2020
Published: January 20, 2021
Abstract
Background: Bacillus Calmette-Guerin (BCG) bladder instillations have been long known to successfully treat non-muscle invasive bladder cancer. The objective of this report is to highlight the first case to our knowledge of Varicella Zoster virus (VZV) shingles reactivation to BCG. Case presentation: An 80-year-old male with history of ParkinsonÂ’s disease and recurring high-grade T1 bladder cancer. Five days after first repeat BCG instillation, patient presented to the emergency room with a progressively worsening rash that started 1 day after treatment, characterized as VZV shingles reactivation. Intravenous acyclovir treatment produced rapid clinical improvement. Conclusion: Reactivation of dormant VZV infection may be a reaction to BCG intravesical instillation. This is, to the authorsÂ’ knowledge, the first documented case of this complication. Although coincidence cannot be completely ruled out, the timing of this case and the context of immunosuppression-immunomodulation inherent to BCG therapy make causality plausible.
Keywords: BCG, shingles, bladder cancer, adverse reaction, varicella zoster, case report, green
