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

Intravesical Bacillus Calmette-Gurin (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.