Question: A 73-year-old man presented with a 7-day history of fever. He also had a history of follicular lymphoma originating from the spleen and underwent splenectomy 12 years ago. In addition, he underwent transurethral resection of a bladder tumor 8 months ago, followed by 2 rounds of bacillus Calmette-Guérin (BCG) therapy. The last course was administered 7 days before presentation. Results of laboratory analysis showed increased levels of alanine transaminase (254 IU/L; normal, <40), aspartate aminotransferase (240 IU/L; normal, <40), γ-glutamyl transpeptidase (386 IU/L; normal, <70), and alkaline phosphatase (1704 IU/L; normal, 115-359).