Objective: To report a case of granulomatous cystitis in a patient receiving bacillus Calmette-Guerin intravesical therapy for urothelial carcinoma in situ.

Methods: A 58-year-old man undergoing BCG intravesical therapy for urothelial carcinoma in situ presented symptoms of intense cystitis. Cystoscopy was performed and several bladder cold biopsies were obtained.

Results: Histopathological analysis demonstrated epithelioid granulomas.

Conclusion: Cystitis arising from BCG therapy is defined as drug-induced or BCG-induced cystitis. Intense cystitis and malaise are a serious complication since it is not possible to distinguish patients with a simple uncomplicated local reaction from those who will develop progressive systemic infection. Cystoscopy and biopsy can be helpful in determining the nature of the condition and are recommended.

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