Multiple organ failure and granulomatous hepatitis following intravesical bacillus Calmette-Guérin instillation.

Acta Clin Belg

Department of Anesthesia and Intensive Care Medicine, AZ Groeninge, Kortrijk, Belgium.

Published: January 2013

Intravesical instillations of Bacillus-Calmette Guérin are widely used in the treatment of superficial bladder carcinoma. Although relatively safe, it has potentially lethal systemic side effects. In this case report a 68 year old patient presented with septic shock and multiple organ failure three days after instillation with Bacillus Calmette-Guérin. After treatment with fluid, vasopressors, broad spectrum antibiotics and antimycobacterial drugs the patient's condition improved. Ten days after admission there was a dramatic increase in bilirubin levels. A liver biopsy revealed granulomatous hepatitis. After the initiation of methylprednisolone the overall condition of the patient improved and serum bilirubin levels returned to normal.

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http://dx.doi.org/10.2143/ACB.67.5.2062692DOI Listing

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