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Case Reports
. 2025 Apr;18(2):337-342.
doi: 10.1007/s12328-024-02086-8. Epub 2024 Dec 28.

Late-onset disseminated BCG infection with hepatosplenomegaly after intravesical BCG immunotherapy in a non-immunocompromised patient

Yugi Hotta  1 , Naoki Yoshioka  2 , Asami Sakamoto  1 , Masayasu Inagaki  3 , Ryota Ito  3 , Kenta Shiraki  4 , Ayami Kiriyama  4 , Toshihiko Yokoyama  3 , Masahiko Fujino  4 , Masao Doisaki  1
Affiliations
Case Reports

Late-onset disseminated BCG infection with hepatosplenomegaly after intravesical BCG immunotherapy in a non-immunocompromised patient

Yugi Hotta et al. Clin J Gastroenterol. 2025 Apr.

Abstract

Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy for bladder cancer rarely leads to disseminated BCG infections, most of which occur early after BCG instillations or in immunocompromised patients. We report late-onset disseminated BCG infection after intravesical BCG immunotherapy in a non-immunocompromised patient. A 78-year-old non-immunocompromised man was admitted with fever and hepatosplenomegaly. He had received intravesical BCG immunotherapy four years earlier. Granulomas were detected in multiple organs and BCG was identified in urine and bone marrow fluid, leading to a diagnosis of disseminated BCG infection. Longitudinal measurements of liver and spleen volumes by computed tomography were useful in determining treatment efficacy.

Keywords: Disseminated Bacillus Calmette–Guérin infection; Hepatosplenomegaly; Late onset; Non-immunocompromised; Organ volume.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Human and animal rights: This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent: Written informed consent to publish this report was obtained from the patient.

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