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Case Report and Clinical Implications

Edward L. Felix, MD; J. Milburn Jessup, MD; Max H. Cohen, MD, PhD

Arch Surg. 1978;113(7):893-896.

Abstract
• Since the introduction of BCG intralesional immunotherapy for melanoma, severe complications, including death, have been reported after treatment in hypersensitized individuals. This is a case report of BCG dissemination with ulceration, skin necrosis, lymphadenitis, and abscess formation following the first intralesional injection of a minimal dose of BCG in a PPD-negative patient. The case demonstrates that severe complications can occur in patients who are not hypersensitized, anergic, or debilitated or who have been treated multiple times. This patient's complication further suggests that migration of BCG after intralesional therapy may play a role in the regression of uninjected nodules seen in some patients.

(Arch Surg 113:893-896, 1978)

Author Affiliations
From the Surgery Branch (Drs Jessup and Cohen), National Cancer Institute, National Institutes of Health, Bethesda, Md, and Department of Surgery, University of Illinois at the Medical Center, Chicago (Dr Felix).

Footnotes
Accepted for publication Jan 17, 1978.

Reprint requests to Department of Surgery, University of Illinois Hospital, 840 S Wood St, Chicago, IL 60612 (Dr Felix).