Skip to main content
Article thumbnail
Location of Repository

Peritoneal tuberculosis and granulomatous hepatitis secondary to treatment of bladder cancer with Bacillus Calmette-Guérin

By Aliye Soylu, Ali T Ince, Hakan Polat, Nurgul Yasar, Aydin Ciltas, Selvinaz Ozkara and Ali I Tasci


Intravesical administration of Bacillus Calmette-Guérin is used as a treatment method in superficial bladder cancer. While it is generally well tolerated, serious side effects may develop. Granulomatous hepatitis cases have been previously reported; however, only one case with tuberculous peritonitis exists in the current literature. We hereby present two cases, one of which is the second tubercular peritonitis case following Bacillus Calmette-Guérin treatment to be reported, and the other a case with granulomatous hepatitis. Complete cure was achieved in both cases with specific therapy. In the patient who developed peritonitis, intravesical Bacillus Calmette-Guérin therapy was recommenced after antituberculosis treatment, and completed without further complications

Topics: Case Report
Publisher: BioMed Central
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2006). A r r e s e M , S o z a A , V i v i a n i P , L e t e l i e r L M : Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis.
  2. (1995). AJ: The induction of Bacillus-Calmette-Guérinactivated killer cells requires the presence of monocytes and T-helper type-1 cells. Cancer Immunol
  3. (2005). AM: Diffuse granulomatous mesenteric disease caused by intravesical Calmette-Guérin instillation masquerading as peritoneal carcinomatosis. Urol Oncol
  4. (1998). AV: Variations in the NRAMP1 gene and susceptibility to tuberculosis in West Africans.
  5. AW: Intracavitary Bacillus Calmette-Guérin in the treatment of superficial bladder tumors.
  6. (2008). Bahcecioglu IH: Clinical review of 23 patients with tuberculous peritonitis: presenting features and diagnosis. J Dig Dis
  7. (1992). Complications of Bacillus Calmette-Guérin immunotherapy. Urol Clin North Am
  8. (1992). Debruyne FM: Incidence and treatment of complications of Bacillus Calmette-Guérin intravesical therapy in superficial bladder cancer.
  9. (2006). Dequin PF: Acute respiratory failure and septic shock induced by Mycobacterium bovis. A rare side effect of intravesical BCG therapy. Presse Med
  10. (1996). Diagnosis of a retroperitoneal BCG abscess in an infant. Case report and review of the literature. Ultraschall Med
  11. (1996). Dingemans-Dumas AM: Granulomatous hepatitis caused by Bacillus Calmette-Guérin (BCG) infection after BCG bladder instillation. Gut
  12. (2005). Ece A: Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey.
  13. (1997). Elevated serum CA 125 concentration in patients with tuberculous peritonitis: a case-control study.
  14. (2006). Granulomatous hepatitis after intravesical BCG treatment for bladder cancer.
  15. (1980). Granulomatous hepatitis as a late complication of BCG immunotherapy. Cancer
  16. (2000). Hillaire-Buys D: Fatal systemic reaction after multiple doses of intravesical Bacillus Calmette-Guérin for polyposis. Ann Pharmacother
  17. (1971). HJ: Suppression of tumor growth at the site of infection with living Bacillus Calmette-Guérin.
  18. (1992). Hypersensitivity systemic reaction following intravesical Bacillus CalmetteGuerin: successful treatment with steroids.
  19. (2004). Isolated renal tuberculosis following intravesical Bacillus Calmette-Guérin therapy for bladder cancer. Urol Int
  20. (1999). Kandiloglu AR: Granulomatous hepatitis following intravesical Bacillus Calmette-Guérin therapy. Int Urol Nephrol
  21. (2000). Kocabalkan F: CA-125; a new marker for diagnosis and followup of patients with tuberculous peritonitis. Dig Liver Dis
  22. (1990). Kushwaha AK: Adenosine deaminase (ADA) in peritoneal tuberculosis: diagnostic value in ascitic fluid and serum. Tubercle
  23. (2005). Late occurrence of bilateral tuberculosis-like epididymo-orchitis after intravesical Bacille Calmette-Guérin therapy for superficial bladder carcinoma. Urology
  24. (2008). LP: Abdominal tuberculosis in a district general hospital: a retrospective review of 86 cases. QJM
  25. (2004). Michielsen PP: Bacillus Calmette-Guérin-induced granulomatous hepatitis in a patient with a superficial bladder carcinoma. Gastroenterol Hepatol
  26. (1993). Mycobacteremia and granulomatous hepatitis following initial intravesical Bacillus Calmette-Guérin instillation for bladder carcinoma.
  27. Non-Malignant pleural effusion.
  28. (1996). Peritoneal tuberculosis: late complication of BCG treatment for bladder carcinoma. Rev Med Interne
  29. (2001). Rensma PL: BCG immunotherapy: be cautious of granulomas. Disseminated BCG infection and mycotic aneurysm as late complications of intravesical BCG instillations.
  30. (2000). SL: Bacillus Calmette-Guerin induced peritonitis in a patient on dialysis.
  31. (1989). Systemic bacillus Calmette-Guérin infection, 'BCGitis', in patients treated by intravesical Bacillus Calmette-Guérin therapy for bladder cancer. Eur Urol
  32. (2001). Syuin T: Two cases of successful treatments with steroid for local and systemic hypersensitivity reaction following intravesical instillation of Bacillus Calmette-Guerin. Hinyokika Kiyo
  33. (2006). The effect of ofloxacin on bacillus calmette-guerin induced toxicity in patients with superficial bladder cancer: results of a randomized, prospective, double-blind, placebo controlled, multicenter study.
  34. (2004). Viertel A: Sepsis and multiple organ failure after BCG-instillation for bladder cancer. Internist
  35. (1987). Whitmore WF Jr: Toxicity of intravesical BCG and its management in patients with superficial bladder tumors. Cancer

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.