A Rare Case of Granulomatous Pneumonitis Due to Intravesical BCG for Bladder Cancer

• Autor(a) principal: Clérigo, Vera
• Data de Publicação: 2019
• Outros Autores: Castro, Ana, Mourato, Teresa, Gomes, Conceição
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10250
• topic: BCG Vaccine; Granuloma/chemically induced; Pneumonia/chemically induced; Urinary Bladder Neoplasms/drug therapy; Granuloma/induzido quimicamente; Neoplasias da Bexiga Urinária/tratamento; Pneumonia/induzida quimicamente; Vacina BCG

Granulomatous pneumonitis is a rare complication of bacillus Calmette-Guerin immunotherapy following intravesical administration of bacillus Calmette-Guerin. The authors present an unusual case of a 67-year-old man who developed mild and non-specific symptoms, following intravesical bacillus Calmette-Guerin instillations. Examinations revealed features of miliary tuberculosis and granuloma suggestive of mycobacterial infection. Anti-tuberculosis treatment resulted in a remarkable improvement in his symptoms and gradually upgrading of radiological appearance. The symptoms were less severe than some others described but this case provides evidence that, even in some cases, specific treatment may be necessary. We highlight the importance of recognizing miliary Mycobacterium bovis as a probable complication of bacillus Calmette-Guerin immunotherapy. The clinical disease course can be mild, despite extensive bilateral miliary nodules on primary presentation.