BCG-related granulomatous hepatitis.
The development of granulomatous lesions in distant organs is an uncommon complication of the immunotherapy with BCG vaccine. We report a case of granulomatous hepatitis after the 12th BCG intravesical instillation (6 weekly followed by 6 monthly) in a 58-year-old man with superficial bladder cancer. The patient was admitted because of fever and jaundice. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. PCR for M. bovis was positive in the liver tissue, confirming the mycobacterial dissemination. Our patient improved clinically with a regimen including both corticosteroids and antituberculosis agents.
Hristea
Adriana
A
University of Medicine and Pharmacy Carol Davila, Bucharest. adriana_hristea@yahoo.com
Neacsu
Adrian
A
Ion
Daniela Adriana
DA
Streinu-Cercel
Adrian
A
Stăniceanu
Florica
F
D000283:Administration, Intravesical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000628:therapy; D002417:Cattle; D004359:Drug Therapy, Combination; D006099:Granuloma / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications* / Q000188:drug therapy; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D016896:Treatment Outcome; D014386:Tuberculosis, Hepatic / Q000188:drug therapy / Q000382:microbiology*; D001749:Urinary Bladder Neoplasms / Q000628:therapy
D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents; D001500:BCG Vaccine