Mycobacterium bovis, a rare causative pathogen of multiple pseudoaneurysms.

Abstract

We report the case of an 85-year-old male with a history of bladder adenocarcinoma treated with 17 intravesical instillations of Bacillus Calmette-Guérin (BCG), who presented with constitutional symptoms and multiple pseudoaneurysms: in the left subclavian, right external iliac, and right superficial femoral arteries. Despite the absence of initial microbiological findings, blood and urine cultures ultimately grew Mycobacterium bovis BCG strain, resistant to pyrazinamide. The clinical course was marked by progressive deterioration and death prior to microbiological confirmation. This case highlights a rare but serious complication of intravesical BCG therapy and underscores the importance of early suspicion and combined surgical and antimicrobial management in patients presenting with unexplained pseudoaneurysms after BCG exposure.