Peritoneal tuberculosis caused by intravesical instillation with Bacillus Calmette-Guerin (BCG) following nephroureterectomy in a patient with bladder and upper tract urothelial cancer: a case report

Background The standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC) is trans-urethral resection of the bladder (TURB) followed by instillation of Bacillus Calmette-Guerin (BCG). The occurrence of peritoneal tuberculosis after intravesical BCG instillation is extremely rare and difficult to diagnose. Methods We report the case of a 79-year-old man with urothelial cell carcinoma (UCC) of the kidney and bladder who developed peritoneal tuberculosis after consecutive TURB and nephroureterectomy followed by intravesical BCG instillation. Further investigation revealed an undiagnosed bladder leak. Conclusion This case serves as a reminder for urologists to be suspicious for urothelium discontinuity when administering BCG shortly after bladder surgery.