Case 29-1998: A 57-Year-Old Man with Fever and Jaundice after Intravesical Instillation of Bacille Calmette-Guerin for Bladder Cancer

Presentation of Case A 57-year-old man was referred to the hospital because of fever and jaundice. The patient had been in good health until four years earlier, when a noninvasive, papillary transitional-cell carcinoma of the bladder, grade 1 on a scale of 1 to 3, was excised. Similar tumors were excised 12 and 18 months later. One year before admission, live bacille Calmette–Guérin (BCG) microorganisms were administered intravesically, with six weekly instillations followed by seven monthly instillations and periodic cystoscopic examinations. There were multiple difficult catheterizations because of total or partial erections and sphincter spasm. The patient recalled having had . . .