title: [Granulomatous hepatitis revealing a Mycobacterium bovis widespread infection following intravesical BCG therapy].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de médecine interne, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France; Université Bordeaux Segalen, 146, rue Léo-Saignat, 33000 Bordeaux, France. Electronic address: loic.raffray33@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Raffray
authors.affiliation: Service de médecine interne, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Rivière
authors.affiliation: Cabinet de médecine générale, 2, rue Larrepunte, 64200 Biarritz, France.
authors.forename: H
authors.initials: H
authors.lastname: Bonnet
authors.affiliation: Service de médecine interne, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France; Université Bordeaux Segalen, 146, rue Léo-Saignat, 33000 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Duffau
authors.affiliation: Service de médecine interne, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France; Université Bordeaux Segalen, 146, rue Léo-Saignat, 33000 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Longy-Boursier
mesh_terms: D000283:Administration, Intravesical; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D019496:Cancer Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D006099:Granuloma / Q000382:microbiology*; D006505:Hepatitis / Q000382:microbiology*; D006801:Humans; D008297:Male; D009164:Mycobacterium Infections / Q000209:etiology*; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000970:Antineoplastic Agents; D001500:BCG Vaccine; D019496:Cancer Vaccines
keywords: BCG; BCG vaccine; Granulomatose disséminée; Granulomatosis; Hepatitis; Hépatite; Immunotherapy; Immunothérapie