{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:13:28Z","timestamp":1788333208746,"version":"build-2803163510"},"reference-count":10,"publisher":"Gobierno de Navarra","issue":"2","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.es"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["An Sist Sanit Navar"],"abstract":"<jats:p>La instilaci\u00f3n intravesical del bacilo de Calmette-Gu\u00e9rin (BCG), una cepa viva atenuada de Mycobacterium bovis, constituye el est\u00e1ndar de tratamiento adyuvante tras la resecci\u00f3n transuretral del carcinoma urotelial no m\u00fasculo-invasivo de riesgo intermedio y alto. Produce una intensa activaci\u00f3n inmunitaria local que ha demostrado reducir las tasas de recidiva y progresi\u00f3n, optimizando as\u00ed el pron\u00f3stico y la calidad de vida. Aunque habitualmente es bien tolerada, pueden surgir complicaciones infecciosas e inflamatorias, tanto locales como sist\u00e9micas.\nPresentamos un caso de diseminaci\u00f3n del BCG al sistema nervioso central tras inmunoterapia intravesical, en el que la naturaleza larvada e inespec\u00edfica de las manifestaciones neurol\u00f3gicas iniciales dificult\u00f3 el diagn\u00f3stico, retrasando el inicio de la terapia dirigida. Se resalta la importancia de revisar los antecedentes m\u00e9dicos y de mantener un elevado \u00edndice de sospecha diagn\u00f3stica en pacientes tratados con inmunoterapia intravesical.<\/jats:p>","DOI":"10.23938\/assn.1145","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:07:34Z","timestamp":1783076854000},"page":"e1145","source":"Crossref","is-referenced-by-count":0,"title":["Meningoencefalitis subaguda tras inmunoterapia mediante instilaci\u00f3n intravesical con BCG","Subacute meningoencephalitis following intravesical BCG instillation immunotherapy"],"prefix":"10.23938","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5095-7021","authenticated-orcid":false,"given":"Edurne","family":"Bidegain Garbala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miren","family":"Arteaga Mazuelas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9311-5461","authenticated-orcid":false,"given":"Vanesa","family":"Jarne Betr\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1698-0264","authenticated-orcid":false,"given":"Mar\u00eda Luisa","family":"Ab\u00ednzano Guill\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10024","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. KAMAT AM, HAHN NM, EFSTATHIOU JA, LERNER SP, MALMSTR\u00d6M PU, CHOI W et al. Bladder cancer. Lancet 2016;388(10061):2796-2810. https:\/\/doi.org\/10.1016\/S0140-6736(16)30512-8","DOI":"10.1016\/S0140-6736(16)30512-8"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. RODR\u00cdGUEZ FABA O, FERN\u00c1NDEZ G\u00d3MEZ JM, GUERRERO RAMOS F, \u00c1LVAREZ MAESTRO M, LEDO CEPERO MJ, UNDA URZAIZ M et al. Documento de consenso sobre las implicaciones de la normalizaci\u00f3n del suministro del Bacillus Calmette-Gu\u00e9rin en el manejo del paciente con tumor vesical no-m\u00fasculo invasivo (TVNMI). Actas Urol Esp 2024;48(10):718-731. https:\/\/doi.org\/10.1016\/j.acuroe.2024.09.005","DOI":"10.1016\/j.acuroe.2024.09.005"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. -P\u00c9REZ-JACOISTE AS\u00cdN MA, FERN\u00c1NDEZ-RUIZ M, L\u00d3PEZ-MEDRANO F, LUMBRERAS C, TEJIDO A, SAN JUAN R et al. Bacillus Calmette-Gu\u00e9rin (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(17):236-254. https:\/\/doi.org\/10.1097\/md.0000000000000119","DOI":"10.1097\/MD.0000000000000119"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. LARSEN ES, JOENSEN UN, POULSEN AM, GOLETTI D, JOHANSEN IS. Bacillus Calmette-Gu\u00e9rin immunotherapy for bladder cancer: a review of immunological aspects, clinical effects and BCG infections. APMIS 2020;128(2): 92-103. https:\/\/doi.org\/10.1111\/apm.13011","DOI":"10.1111\/apm.13011"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. B\u00d6HLE A, BRANDAU S. Immune mechanisms in bacillus Calmette-Guerin immunotherapy for superficial bladder cancer. J Urol 2003;170(3):964-969. https:\/\/doi.org\/10.1097\/01.ju.0000073852.24341.4a","DOI":"10.1097\/01.ju.0000073852.24341.4a"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. BOWYER L, HALL RR, READING J, MARSH MM. The persistence of bacille Calmette-Gu\u00e9rin in the bladder after intravesical treatment for bladder cancer. Br J Urol 1995;75(2):188-192. https:\/\/doi.org\/10.1111\/j.1464-410X.1995.tb07309.x","DOI":"10.1111\/j.1464-410X.1995.tb07309.x"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. KOCH GE, SMELSER WW, CHANG SS. Side effects of intravesical BCG and chemotherapy for bladder cancer: What they are and how to manage them. Urology 2021;149:11-20. https:\/\/doi.org\/10.1016\/j.urology.2020.10.039","DOI":"10.1016\/j.urology.2020.10.039"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. GONZALEZ OY, MUSHER DM, BRAR I, FURGESON S, BOKTOUR MR, SEPTIMUS EJ et al. Spectrum of bacille Calmette-Gu\u00e9rin (BCG) infection after intravesical BCG immunotherapy. Clin Infect Dis 2003; 36(2):140-148. https:\/\/doi.org\/10.1086\/344908","DOI":"10.1086\/344908"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. CABAS P, RIZZO M, GIUFFR\u00c8 M, ANTONELLO RM, TROMBETTA C, LUZZATI R et al. BCG infection (BCGitis) following intravesical instillation for bladder cancer and time interval between treatment and presentation: A systematic review. Urol Oncol 2021;39(2):85-92. https:\/\/doi.org\/10.1016\/j.urolonc.2020.11.037","DOI":"10.1016\/j.urolonc.2020.11.037"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. LADR\u00d3N DE GUEVARA D, CATAL\u00c1N P, HERN\u00c1NDEZ C, ZHINDON JP. Valor del PET\/CT semicuantitativo (SUVmax) en el estudio de n\u00f3dulo pulmonar s\u00f3lido. Rev Chil Enferm Respir 2019;35(2):116-123. https:\/\/dx.doi.org\/10.4067\/S0717-73482019000200116","DOI":"10.4067\/S0717-73482019000200116"}],"container-title":["Anales del Sistema Sanitario de Navarra"],"original-title":[],"link":[{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/117053\/88409","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/117053\/88409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:19:57Z","timestamp":1788329997000},"score":1,"resource":{"primary":{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/view\/117053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,24]]}},"URL":"https:\/\/doi.org\/10.23938\/assn.1145","relation":{},"ISSN":["2340-3527","1137-6627"],"issn-type":[{"value":"2340-3527","type":"electronic"},{"value":"1137-6627","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}