Disseminated Miliary Tuberculosis Following Intravesical BCG Therapy: A Rare But Serious Complication

Authors

  • Al-Taiee Baker Department of Radiology and Nuclear Medicine, Hanusch-Hospital, Vienna, Austria
  • Mejdoubi Lamiss Department of Pathology, Hanusch-Hospital, Vienna, Austria
  • Slavicek Jakob Department of Radiology and Nuclear Medicine, Hanusch-Hospital, Vienna, Austria
  • Hergan Klaus Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Zandieh Shahin Department of Radiology and Nuclear Medicine, Hanusch-Hospital, Vienna, Austria/Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria

DOI:

https://doi.org/10.3941/jrcr.5809

Abstract

Intravesical Bacillus Calmette-Guérin (BCG) therapy is a standard immunotherapy for non-muscle-invasive bladder cancer (NMIBC). Although generally safe, systemic dissemination leading to miliary tuberculosis (TB) is a rare but potentially life-threatening complication. We present a case of a 71-year-old male who developed miliary TB three weeks after the third cycle of BCG instillation. Chest CT revealed diffuse, randomly distributed <2 mm nodules. PCR confirmed Mycobacterium bovis infection. Treatment with isoniazid, rifampicin, and ethambutol led to clinical improvement. Radiologists should be aware of this rare complication to ensure prompt diagnosis and management.

71-year-old male with disseminated tuberculosis following BCG therapy. FINDINGS: Axial chest CT shows numerous <2 mm randomly distributed nodules (arrow) involving both lungs concordant with miliary tuberculosis. TECHNIQUE: Axial contrast-enhanced chest CT using 120 kV, 180 mAs, 1.0 mm slice thickness, 100 mL iodinated contrast medium during venous phase.

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Published

2025-08-30

Issue

Vol. 19 No. 8 (2025)

Section

Genitourinary Radiology

License

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