{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:49:29Z","timestamp":1789555769854,"version":"build-2803163510"},"reference-count":8,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Intra-vesical instillation of bacillus Calmette\u2013Gu\u00e9rin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.<\/jats:p>","DOI":"10.3390\/idr13030057","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T12:03:27Z","timestamp":1625141007000},"page":"611-618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette\u2013Gu\u00e9rin for Treatment of Bladder Cancer"],"prefix":"10.3390","volume":"13","author":[{"given":"Elsa Alves","family":"Branco","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4099-002 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Duro","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4099-002 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Brito","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4099-002 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f3nio","family":"Sarmento","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4099-002 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1136\/gut.38.4.616","article-title":"Granulomatous hepatitis caused by Bacillus Calmette-Guerin (BCG) infection after BCG bladder instillation","volume":"38","author":"Leebeek","year":"1996","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/MD.0000000000000119","article-title":"Bacillus Calmette-Gu\u00e9rin (BCG) Infection Following Intravesical BCG Administration as Adjunctive Therapy For Bladder Cancer","volume":"93","author":"Lumbreras","year":"2014","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4137\/CCRep.S39904","article-title":"Disseminated Mycobacterium bovis Infection Complicating Intravesical BCG Instillation for the Treatment of Superficial Transitional Cell Carcinoma of the Bladder","volume":"9","author":"ElZein","year":"2016","journal-title":"Clin. 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Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000471561","article-title":"Systemic bacillus Calmette-Gu\u00e9rin infection, \u2019BCGitis\u2019, in patients treated by intravesical Bacillus Calmette-Gu\u00e9rin therapy for bladder cancer","volume":"16","author":"Steg","year":"1989","journal-title":"Eur. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"301","DOI":"10.12998\/wjcc.v2.i7.301","article-title":"Disseminated infection due to Mycobacterium bovis after intravesical BCG instillation","volume":"2","year":"2014","journal-title":"World J. Clin. Cases"}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/13\/3\/57\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:24:40Z","timestamp":1760163880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/13\/3\/57"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["idr13030057"],"URL":"https:\/\/doi.org\/10.3390\/idr13030057","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,1]]}}}