Patient B was a 67-year-old male who presented to ED with weight loss and night sweats. His complete blood cell count was within normal limits. Serum C-reactive protein was elevated at 41.1 mg/L. He had received fifteen intravesical BCG instillations for his low-grade papillary urothelial carcinoma and his last BCG instillation was 4 months prior to his ED presentation. His medical profile was otherwise negative apart from a remote uncomplicated appendectomy. Outpatient abdominal ultrasound was suspicious for periaortic lymphadenopathy. Follow-up CT scan of the abdomen and pelvis showed a centrally low density and peripherally enhancing periaortic collection measuring up to 5 cm x 1 cm x 4.6 cm in the infrarenal region. At this level, a focal outpouching arising from the aorta posteriorly measuring up to 0.8 cm x 2.2 cm x 0.9 cm (APxTRVxCC) was suspicious for a mycotic aneurysm (Fig. 2). A percutaneous CT-guided biopsy of the periaortic collection demonstrated necrotizing granulomatous inflammation, highly suspicious for BCGosis. This patient's mycotic aneurysm was treated with a surgical resection of the infected infrarenal aortic segment and repaired using an autologous graft harvested from the patient's left femoral vein. He had an uneventful postoperative course in the hospital and was discharged on a standard antituberculosis medication regime including isoniazid, rifampin, pyrazinamide, ethambutol, and Vitamin B6. Patient has remained asymptomatic awaiting six-month follow-up imaging studies.