GRANULOMATOUS HEPATITIS CAUSED BY BACILLUS-CALMETTE-GUERIN (BCG) INFECTION AFTER BCG BLADDER INSTILLATION

Background-Bladder instillations with Bacillus Calmette-Guerin (BCG) a re commonly used as immunotherapy for bladder carcinoma. Sometimes pat ients experience serious systemic side effects, such as sepsis or pneu monitis. Granulomatous hepatitis is a rare serious side effect, which has been considered a hypersensitivity reaction to BCG. Patient-The fi rst case of granulomatous hepatitis after BCG bladder instillation in which mycobacteria were identified by staining techniques and mycobact erial DNA was detected in liver tissue using the polymerase chain reac tion is reported. Conclusion-The granulomatous hepatitis was caused by BCG infection of the liver after haematogenous dissemination of BCG, rather than hypersensitivity.