15th July 2024

A 65-year-old man is known to have bladder cancer. He has had transurethral resection of the cancer

A 65-year-old man is known to have bladder cancer. He has had transurethral resection of the cancer 4 months ago, and started his first round of intravesical BCG yesterday. He presents today to the acute medical unit with myalgia and flu like symptoms. LFTs show an ALT: 487 u/L, AST: 245 u/L, GGT: 611 u/L, total bilirubin: 64. Hb 16, Cr: 80, Urea: 4. Serology for viral hepatitis A, B, C are all negative, as is HIV and CMV and EBV serology. He is on Ramipril, levothyroxine and clopidogrel.

What is the most likely cause of his presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.