BCG-osis: a complication after intravesical BCG immunotherapy

BCG, or live attenuated Mycobacterium bovis, intravesical immunotherapy is now an established component of the standard of care for bladder cancer following transurethral resection of bladder tumour. The following case demonstrates the rare complication of disseminated BCG (BCG-osis) that may arise after the aforementioned therapy. Patients at increased risk of this complication include those who are immunocompromised, above the age of 70 and patients who have had traumatic catheterisation. Diagnosis can be made with or without microbiology and management includes a multidrug regimen. It is important to recognise the signs and symptoms of BCG-osis and postpone future intravesical instillation of BCG if there is traumatic catheterisation. Future instillation should be completely discontinued if a patient develops disseminated M. bovis.