[Rare pulmonary complication in intravesical BCG treatment].
We report a case of epithelioid granulomatous allergic lung disease in a patient given intra-bladder BCG therapy for treatment of a tumor. This uncommon complication is sometimes related to bacterial dissemination or to an immunoallegic reaction occurring from the third to eigth week after onset of the instillation. Clinically, the patient presents a flu-like syndrome. The standard chest X-ray followed by computed tomography, demonstrates the extension of the pulmonary lesions. Miliary dissemination is rarely reported (10 cases in the literature). Histological proof can be obtained from an endoscopic bronchial biopsy or a surgical specimen of the pulmonary parenchyma. Treatment is based on corticosteroid therapy in combination with antituberculosis antibiotics. Prognosis is generally good with treatment.
Audigier
C
C
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon.
Nesme
P
P
Perol
M
M
Guerin
J C
JC
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D015769:Granuloma, Respiratory Tract / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D011379:Prognosis; D013256:Steroids; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents; D001500:BCG Vaccine; D013256:Steroids