Frontiers in Immunology (Aug 2021)
Case Report: Acquired Disseminated BCG in the Context of a Delayed Immune Reconstitution After Hematological Malignancy
- Vincent Gies,
- Vincent Gies,
- Vincent Gies,
- Yannick Dieudonné,
- Yannick Dieudonné,
- Florence Morel,
- Florence Morel,
- Wladimir Sougakoff,
- Wladimir Sougakoff,
- Raphaël Carapito,
- Raphaël Carapito,
- Aurélie Martin,
- Noëlle Weingertner,
- Léa Jacquel,
- Léa Jacquel,
- Fabrice Hubele,
- Cornelia Kuhnert,
- Sophie Jung,
- Sophie Jung,
- Frederic Schramm,
- Pierre Boyer,
- Yves Hansmann,
- François Danion,
- Anne-Sophie Korganow,
- Anne-Sophie Korganow,
- Aurélien Guffroy,
- Aurélien Guffroy
Affiliations
- Vincent Gies
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, Strasbourg, France
- Vincent Gies
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Vincent Gies
- Université de Strasbourg, Faculty of Pharmacy, Illkirch, France
- Yannick Dieudonné
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, Strasbourg, France
- Yannick Dieudonné
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Florence Morel
- APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Laboratoire de Bactériologie-Hygiène, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), Paris, France
- Florence Morel
- Sorbonne Universités, Inserm, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), UMR 1135, Paris, France
- Wladimir Sougakoff
- APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Laboratoire de Bactériologie-Hygiène, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), Paris, France
- Wladimir Sougakoff
- Sorbonne Universités, Inserm, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), UMR 1135, Paris, France
- Raphaël Carapito
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Raphaël Carapito
- Immunology Laboratory, Strasbourg University Hospital, Strasbourg, France
- Aurélie Martin
- Department of Infectiology, Strasbourg University Hospital, Strasbourg, France
- Noëlle Weingertner
- Departement of Pathology, Strasbourg University Hospital, Strasbourg, France
- Léa Jacquel
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, Strasbourg, France
- Léa Jacquel
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Fabrice Hubele
- Departement of Nuclear Medicine and Molecular Imaging, ICANS, University Hospital of Strasbourg, Strasbourg, France
- Cornelia Kuhnert
- 0Department of Internal Medicine, Strasbourg University Hospital, Strasbourg, France
- Sophie Jung
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Sophie Jung
- 1Hôpitaux Universitaires de Strasbourg, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Pôle de Médecine et de Chirurgie Bucco-Dentaires, Strasbourg, France
- Frederic Schramm
- 2Laboratory of Bacteriology, Strasbourg University Hospital, Virulence bactérienne Précoce UR7290-Lyme Borreliosis Group, FMTS-CHRU Strasbourg, Institut de Bactériologie, Strasbourg, France
- Pierre Boyer
- 2Laboratory of Bacteriology, Strasbourg University Hospital, Virulence bactérienne Précoce UR7290-Lyme Borreliosis Group, FMTS-CHRU Strasbourg, Institut de Bactériologie, Strasbourg, France
- Yves Hansmann
- Department of Infectiology, Strasbourg University Hospital, Strasbourg, France
- François Danion
- Department of Infectiology, Strasbourg University Hospital, Strasbourg, France
- Anne-Sophie Korganow
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, Strasbourg, France
- Anne-Sophie Korganow
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Aurélien Guffroy
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, Strasbourg, France
- Aurélien Guffroy
- Université de Strasbourg, INSERM UMR-S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- DOI
- https://doi.org/10.3389/fimmu.2021.696268
- Journal volume & issue
-
Vol. 12
Abstract
ContextDisseminated infections due to Mycobacterium bovis Bacillus Calmette-Guérin (BCG) are unusual and occur mostly in patients with inborn error of immunity (IEI) or acquired immunodeficiency. However, cases of secondary BCGosis due to intravesical BCG instillation have been described. Herein, we present a case of severe BCGosis occurring in an unusual situation.Case DescriptionWe report one case of severe disseminated BCG disease occurring after hematological malignancy in a 48-year-old man without BCG instillation and previously vaccinated in infancy with no complication. Laboratory investigations demonstrated that he was not affected by any known or candidate gene of IEI or intrinsic cellular defect involving IFNγ pathway. Whole genome sequencing of the BCG strain showed that it was most closely related to the M. bovis BCG Tice strain, suggesting an unexpected relationship between the secondary immunodeficiency of the patient and the acquired BCG infection.ConclusionThis case highlights the fact that, in addition to the IEI, physicians, as well as microbiologists and pharmacists should be aware of possible acquired disseminated BCG disease in secondary immunocompromised patients treated in centers that administrate BCG for bladder cancers.
Keywords
