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

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.