Case Report: A rare case of BCGitis in a patient with bladder cancer treated with the BCG vaccine

Abstract

The Bacillus Calmette Guérin (BCG) vaccine was initially produced as a vaccine against tuberculosis. BCG is an attenuated live strain of Mycobacterium bovis and has been widely used as an immunotherapy over the last years in bladder cancer. We describe a case of a 61-year-old Caucasian male with previous bladder cancer, who had been treated for the last 15 months with instillation of BCG, admitted with 3-week evolution history of fever (38ºC), asthenia, anorexia and a weight loss of 6kg. The patient’s condition deteriorated leading to sepsis. A liver biopsy was performed showing granulomatous dispersed through all the parenchyma. Empirical therapy for M. bovis was started with good response. Even though it is rare, BCGitis must be ruled out in any patient submitted to immunotherapy with BCG and prompt therapy started if disseminated disease is present, which improves the outcome.