Systemic bacillus Calmette-Guérin (BCG) infection and accompanying warm autoimmune haemolytic anaemia following intravesical BCG immunotherapy
  • Alper Tuna Güven
    Department of Internal Medicine, Division of General Internal Medicine, Başkent University Faculty of Medicine, Ankara, Turkey
  • Yusuf Ziya Demiroğlu
    Department of Infectious Diseases, Başkent University Adana Hospitals, Ankara, Turkey
  • Nazım Emrah Koçer
    Department of Pathology, Başkent University Adana Hospitals, Ankara, Turkey


Mycobacterium bovis, urinary bladder neoplasms, anaemia, immunotherapy


Intravesical bacillus Calmette-Guérin (BCG) is used for urothelial carcinoma. Systemic side effects are rare and commonly include organ involvement but rarely include bone marrow. We describe a patient who had received intravesical BCG and presented shortly afterwards with constitutional symptoms. Initial work-up revealed pancytopenia and immune haemolysis. He was presumptively diagnosed with systemic BCG infection and secondary warm autoimmune haemolytic anaemia. Isoniazid, rifampin and ethambutol was started. The bone marrow biopsy revealed granulomas. Within 6 weeks of treatment, the patient's clinic and laboratory results were dramatically improved. A high level of suspicion is crucial for diagnosis and treatment.



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    Published: 2023-08-10
    Issue: 2023: Vol 10 No 9 (view)

    How to cite:
    Güven AT, Demiroğlu YZ, Koçer NE. Systemic bacillus Calmette-Guérin (BCG) infection and accompanying warm autoimmune haemolytic anaemia following intravesical BCG immunotherapy. EJCRIM 2023;10 doi:10.12890/2023_004009.