[Miliary dissemination with pulmonary involvement secondary to intravesical immunotherapy with Calmette-Guérin...

We describe the case of a 67-years-old man who underwent transurethral resection and immunotherapy with Calmette-Guérin bacillus solution (CGB) for superficial transitional carcinoma of the bladder. After a series of intravesical irrigations with CGB, the patient developed fever, asthenia and persistent anorexia and was hospitalized. After testing he was diagnosed of miliary tuberculosis due to CGB and died in spite of tuberculostatic therapy. Hematogenous dissemination, a rare but serious complication of vesical irrigation with CGB, is thought to be more common than previously suspected. It should be suspected in all patients receiving CGB when a compatible clinical picture presents. An understanding of this complication and early establishment of specific treatment is the only wat to improve prognosis.