Granulomatous pneumonitis following intravesical BCG. What therapy is needed?
A 68-year-old man developed fever, cough, and dyspnea after intravesical bacillus Calmette-Guerin (BCG). Chest radiograph revealed diffuse reticulonodular infiltrates with caseating granulomas on transbronchial biopsy specimen. Cultures were negative and the patient's condition improved with corticosteroids. The mechanism for BCG-induced granulomatous inflammation is poorly understood. Optimal therapy includes corticosteroids.
LeMense
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GP
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston.
Strange
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C
D000283:Administration, Intravesical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000628:therapy; D006099:Granuloma / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000628:therapy
D000305:Adrenal Cortex Hormones; D001500:BCG Vaccine