BCG septicemia after radical cystectomy: a rare postoperative complication following BCG therapy

It is reported a case of life-threatening septic shock due to BCG septicemia after radical cystectomy in a patient with a previous treatment with BCG therapy. In the absence of response to standard antimicrobial therapy and a negative CT scan, a PCR-based technique detected the presence of BCG bacilli in bloodstream. Immediate antimycobacterial therapy resolved the sepsis, thus suggesting either the awareness of this infection or the prompt antimycobacterial therapy as the key for the appropriate management. Furthermore, isoniazid prophylaxis should be taken into consideration in patients with history of intravesical BCG therapy undergoing cystectomy.