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Open Access 01-12-2011 | Case report

Granulomatous hepatitis, choroiditis and aortoduodenal fistula complicating intravesical Bacillus Calmette-Guérin therapy: Case report

Authors: Cindy Q Gao, Rozina Mithani, Jack Leya, Lesley Dawravoo, Arvin Bhatia, John Antoine, Felipe De Alba, Peter A Russo, Claus J Fimmel

Published in: BMC Infectious Diseases | Issue 1/2011

Abstract

Background

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is the treatment of choice for superficial bladder carcinoma. Complications of BCG therapy include local infections and disseminated BCG infection with multiple endorgan complications.

Case Presentation

We report a case of disseminated, post-treatment BCG infection that initially presented with granulomatous hepatitis and choroiditis. After successful anti-mycobacterial therapy and resolution of the hepatic and ocular abnormalities, the patient developed an acute upper gastrointestinal hemorrhage from an aortoduodenal fistula that required emergency surgery. The resection specimen revealed multifocal, non-caseating granulomas, indicating mycobacterial involvement.

Conclusions

This case highlights the varied end organ complications of disseminated BCG infection, and the need for vigilance even in immuno-competent patients with a history of intravesical BCG treatment.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/11/260/prepub

Title: Granulomatous hepatitis, choroiditis and aortoduodenal fistula complicating intravesical Bacillus Calmette-Guérin therapy: Case report
Authors: Cindy Q Gao
Rozina Mithani
Jack Leya
Lesley Dawravoo
Arvin Bhatia
John Antoine
Felipe De Alba
Peter A Russo
Claus J Fimmel
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Infectious Diseases / Issue 1/2011
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/1471-2334-11-260

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