Systemic bacillus-Calmette Guerin infection after transurethral administration for superficial bladder carcinoma

It is well known that intravesical bacillus Calmette-Guerin therapy is a safe and effective treatment for superficial bladder carcinoma with few serious complications. However, we report a case of pneumonitis, hepatitis, azotemia, fever and pancytopenia in a patient after transurethral administration of bacillus Calmette-Guerin. Even though severe systemic complications are rare, patients who have high fevers of signs of other systemic manifestations require documentation of the extent of the infection. Also, we address the use of prophylactic antituberculous drugs, not only to prevent these symptoms but also to raise the questions of diminishing the immunological effect of the treatment.