Risk factors for infection beyond the bladder:
(1) patient immunocompromised, especially with defective cellular immunity
(2) improper administration (inexperienced, difficulty performing, other)
(3) BCG administration shortly after extensive tumor resection
(4) traumatic catheterization or urethral trauma
(5) high voiding pressure
Infections that have been reported:
(1) localized abscess (psoas muscle, other)
(2) disseminated disease with miliary spread
(3) pneumonitis
(4) granulomatous hepatitis
(5) pancytopenia (due to involvement of the bone marrow)
Clinical findings:
(1) fever
(2) malaise
(3) symptoms based on extent of the infection
(4) positive culture for Mycobacterium bovis identical to the strain of BCG administered
Most patients respond to a short course of isoniazid therapy.
Differential diagnosis:
(1) anaphylaxis
(2) urosepsis
