[Granulomatous hepatitis revealing a Mycobacterium bovis widespread infection following intravesical BCG therapy]

Abstract

Introduction: Intravesical therapy with bacillus Calmette-Guérin (BCG) has proved to be effective in the treatment of superficial bladder tumors. Side-effects include local infections and rarely disseminated BCG infection with multiple end organ complications such as granulomatous hepatitis, pneumonitis, aortitis and bone marrow involvement.

Case report: We report an 83-year-old man who presented with chronic granulomatous hepatitis. This was related to intravesical BCG therapy received two years earlier for superficial bladder cancer. Aortitis, splenic infarction and hematopoietic involvement were also diagnosed. Outcome was favorable following adapted antibiotic course.

Conclusion: This case report highlights the possibility of widespread BCG infection following intravesical treatment, and the need for vigilance in patients with a history of such a therapy even several years later.

Keywords: BCG; BCG vaccine; Granulomatose disséminée; Granulomatosis; Hepatitis; Hépatite; Immunotherapy; Immunothérapie.