BCG-related granulomatous hepatitis.

The development of granulomatous lesions in distant organs is an uncommon complication of the immunotherapy with BCG vaccine. We report a case of granulomatous hepatitis after the 12th BCG intravesical instillation (6 weekly followed by 6 monthly) in a 58-year-old man with superficial bladder cancer. The patient was admitted because of fever and jaundice. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. PCR for M. bovis was positive in the liver tissue, confirming the mycobacterial dissemination. Our patient improved clinically with a regimen including both corticosteroids and antituberculosis agents.