Spectrum of bacille Calmette-Guérin (BCG) infection after intravesical BCG immunotherapy

Clin Infect Dis. 2003 Jan 15;36(2):140-8. doi: 10.1086/344908. Epub 2003 Jan 3.


Intravesical instillation of bacille Calmette-Guérin (BCG) effectively treats transitional cell carcinoma of the bladder. Occasionally, BCG infection complicates such treatment. In some patients, infection appears early (within 3 months after instillation) and is characterized by generalized symptoms, with pneumonitis and hepatitis. Late-presentation disease occurs >1 year after the first BCG treatment and usually involves focal infection of the genitourinary tract (the site at which bacteria were introduced) and/or other sites that are typical for reactivation of mycobacterial disease, such as the vertebral spine or the retroperitoneal tissues. Noncaseating granulomas are found in the majority of cases, whether early or late. Most patients respond to treatment with antituberculous drugs; in early-presentation disease, when features of hypersensitivity predominate, glucocorticosteroids are sometimes added. Late localized infection often requires surgical resection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • BCG Vaccine / adverse effects*
  • BCG Vaccine / therapeutic use
  • Carcinoma, Transitional Cell / drug therapy
  • Hepatitis / drug therapy
  • Hepatitis / etiology
  • Humans
  • Immunotherapy / adverse effects*
  • Male
  • Middle Aged
  • Mycobacterium Infections / drug therapy
  • Mycobacterium Infections / etiology*
  • Mycobacterium Infections / microbiology
  • Mycobacterium bovis*
  • Pneumonia / drug therapy
  • Pneumonia / etiology
  • Urinary Bladder Neoplasms / drug therapy


  • BCG Vaccine