Disseminated Bacillus Calmette-Guérin Infection Detected on FDG PET/CT Following Intravesical Bacillus Calmette-Guérin Therapy.

We report the case of a 64-year-old man who presented with back pain, anorexia, and weight loss 9 months following bacillus Calmette-Guérin immunotherapy for high-grade transitional cell carcinoma of the bladder. A FDG PET/CT was performed, which demonstrated osteolysis and intense FDG avidity of the T6/T7 and T8/T9 vertebral endplates. In addition, an aneurysm with FDG-avid soft tissue was present of the distal left common iliac artery. The provisional diagnosis was disseminated bacillus Calmette-Guérin infection, resulting in spondylodiscitis and a mycotic aneurysm. A CT-guided vertebral biopsy confirmed the presence of Mycobacterium tuberculosis DNA on polymerase chain reaction testing.