Diagnostically Challenging Disseminated Bacillus Calmette-Guerin Infection With Lung and Liver Involvement: A Case
Shinichi Chang1, Makiko Yomota1, Ayumi Takizawa2
1Department of Respiratory Medicine Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital Tokyo Japan.
Respirology Case Reports
|December 22, 2025
Summary
Disseminated Bacillus Calmette-Guerin (BCG) infection, a rare complication of bladder cancer treatment, can present with non-specific symptoms. This case highlights the importance of imaging and biopsy for diagnosis when cultures are negative.
Area of Science:
- Oncology
- Infectious Diseases
- Pulmonology
Background:
- Intravesical Bacillus Calmette-Guerin (BCG) is a standard treatment for non-muscle-invasive bladder cancer.
- Disseminated BCG infection is a rare but serious complication, often challenging to diagnose microbiologically.
Purpose of the Study:
- To report a case of disseminated BCG infection presenting with diffuse lung disease.
- To emphasize the diagnostic utility of radiological and histopathological findings in suspected disseminated BCG infection.
Main Methods:
- Case report of a 73-year-old male patient receiving intravesical BCG therapy.
- Clinical presentation of persistent fever, dyspnea, and jaundice.
- Diagnostic workup included chest CT, lung and liver biopsies.
Main Results:
- Chest CT revealed diffuse micronodules.
- Lung and liver biopsies showed non-caseating granulomas.
- Disseminated BCG infection was suspected despite negative microbiological tests.
Conclusions:
- Radiological and histopathological findings are crucial for diagnosing diffuse lung diseases, including BCG complications.
- Early suspicion and appropriate management are vital for patient outcomes.
- This case underscores the diagnostic challenges and importance of comprehensive evaluation in disseminated BCG infection.
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