Assuntos
Antituberculosos/uso terapêutico , Exsudatos e Transudatos/citologia , Derrame Pleural/microbiologia , Tuberculose Pleural/diagnóstico , Idoso , Antituberculosos/administração & dosagem , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Derrame Pleural/diagnóstico por imagem , Toracentese/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Tuberculose Pleural/tratamento farmacológico , Tuberculose Pleural/patologia , Tuberculose Pleural/cirurgiaRESUMO
Medical history A 77-year-old patient with transurethral resection of a bladder tumor was transferred due to persistent fever and progressive dyspnea despite antibiotic therapy for suspected urinary tract infection. Repeating the medical history revealed that a BCG immunotherapy of his non-muscle-invasive bladder carcinoma was performed the day before fever developed. Therefore, BCGitis was suspected. Examinations Laboratory parameters showed pancytopenia, elevated liver enzymes, eleveated C-reactive protein and hypoxemia. The CT scan showed multiple miliary lesions of the lung, the bone marrow biopsy revealed granuloma. Diagnosis M. bovis BCG was cultured from urine and bronchoalveolar lavage fluid. Therapy and course Therapy with isoniazide, rifampine, ethambutol and initially prednisolone caused rapid improvement. Conclusion BCGitis is a rare complication of BCG immunotherapy of non-muscle-invasive bladder carcinoma.