'BCGitis' - sepsis following BCG treatment for bladder carcinoma

Bacillus Calmette-Guerin (BCG) immunotherapy is an important advance in the management of superficial and in-situ transitional-cell carcinoma of the bladder. The advantages of treatment with BCG clearly outweigh the risks: all many as 80% of patients will have complete, long-term elimination of tumor cells, while fewer than 5% will have other than minor adverse reactions to the treatment. We describe a 37-year-old man who underwent 2 courses of BCG treatment for superficial carcinoma of the bladder. The second course was complicated by trauma to the bladder. He developed fever, hepatitis, pneumonitis and pancytopenia, a clinical syndrome referred to as 'BCGitis'. Treatment with antimycobacterial drugs accompanied by steroids led to recovery.