Acute Hepatitis and Pneumonitis Caused by Disseminated Bacillus Calmette-Guérin Infection

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is the treatment of choice for superficial bladder carcinoma. We report a case of disseminated BCG infection in an early stage bladder cancer patient that initially presented with hepatitis followed by pneumonitis and sepsis. A complete clinical response was achieved in 14 days with anti-mycobacterial therapy and prednisolone. Disseminated BCG is a rare treatment complication and is likely a combination of direct infection and hypersensitivity.

[1]  M. Moussa,et al.  Granulomatous hepatitis caused by Bacillus Calmette-Guerin (BCG) infection after BCG bladder instillation: A case report , 2018, Urology Case Reports.

[2]  A. Morales,et al.  INTRACAVITARY BACILLUS CALMETTE‐GUERIN IN THE TREATMENT OF SUPERFICIAL BLADDER TUMORS , 1976, The Journal of urology.

[3]  S. Naito,et al.  Adverse drug reactions of intravesical bacillus Calmette–Guérin instillation and risk factors of the development of adverse drug reactions in superficial cancer and carcinoma in situ of the bladder , 2005, International journal of urology : official journal of the Japanese Urological Association.

[4]  G. T. Garyfallou Mycobacterial sepsis following intravesical instillation of bacillus Calmette-Guérin. , 1996, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[5]  D. Proctor,et al.  Mycobacteremia and granulomatous hepatitis following initial intravesical bacillus Calmette-Guerin instillation for bladder carcinoma. , 1993, The American journal of gastroenterology.

[6]  F M Debruyne,et al.  Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer. , 1992, The Journal of urology.

[7]  J. Dehaven,et al.  Antibiotic and steroid therapy of massive systemic bacillus Calmette-Guerin toxicity. , 1992, The Journal of urology.

[8]  A. Morell,et al.  [BCG sepsis as a fatal complication of BCG vaccination]. , 1979, Swiss medical weekly.