We describe a patient with a serious urinary tract infection due to Actinomyces bernardiae (formerly classified as CDC [Centers for Disease Control and Prevention, Atlanta] fermentative coryneform group 2). Our patient had long-standing bladder dysfunction and developed hydroureteronephrosis, renal lithiasis, perirenal abscesses, and septicemia. A. bernardiae is distinct from Actinomyces pyogenes and several CDC coryneform groups.

A 71-year-old male patient with a superficial transitional cell carcinoma of the urinary bladder developed high fever and jaundice, accompanied by progressively increasing serum aminotransferase activities, 2 weeks after the fourth local instillation with an attenuated live strain of Mycobacterium bovis [bacillus Calmette-Guérin (BCG)]. A liver biopsy showed non-caseating granulomatous hepatitis. Cultures for mycobacteria were negative. Mycobacterial DNA was not detected in liver tissue using the polymerase chain reaction. Empirical treatment with rifampicin and isoniazid was started, resulting in partial recovery. After 6 months of therapy, however, serum aminotransferase activities were still twice the upper limit of normal. A second liver biopsy still demonstrated several granulomas. Only after addition of prednisolone, liver tests completely normalized. Also histologically the lesions improved dramatically. This suggests that the BCG hepatitis was at least partially caused by a hypersensitivity reaction. Our patient is the first reported case of BCG hepatitis with histological follow-up under therapy.

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Non-renal urogenital Wegener's granulomatosis is considered to be rare. Generally it occurs in a setting of concurrent multisystem disease or in patients already diagnosed as having Wegener's granulomatosis. We present a patient with a penile ulceration related to a destructive urethritis, as presentation of a relapse of Wegener's granulomatosis.

In an 11-year-old boy with intermittent colicky flank pain for several years unilateral obstruction caused by benign ureteral fibrous polyps was found. The radiologic characteristics are discussed and the need for conservative surgery is stressed.