title: [A case with hepatitis and interstitial pneumonitis caused by intravesical bacillus Calmette-Guérin (BCG) instillation].
abstract: A 49-year man, with past history of right total nephroureterectomy due to urothelial carcinoma of the right renal pelvis in September 2006 and left partial ureterectomy due to contralateral ureteral recurrence in October 2007, underwent TUR-BT due to superficial high-grade recurrent bladder cancer. After TUR-Bt, he was treated with intravesical Bacillus Calmette-Guérin (BCG) instillation at weekly intervals. Just after 5th instillation, he suffered a continuous high fever up to 38 degrees C and complained of general fatigue. Chest CT showed diffuse micronodular shadows in both lungs, and serum liver enzyme was markedly elevated. All cultures from his sputum and urine were negative for mycobacterium tuberculosis. TB-PCR test and quantiferon were also negative. These findings together with no improvement of the symptoms with anti-tuberculous treatment finally made us to judge that this was due to a hypersensitivity reaction to BCG. Soon after pulse steroid therapy, body temperature was normalized and the abnormal findings of the lung and liver disappeared.
authors.affiliation: Department of Urology, Kagawa University Graduate School of Medicine.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uetsuki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hirama
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsunemori
authors.forename: Motoki
authors.initials: M
authors.lastname: Yamashita
authors.forename: Masashi
authors.initials: M
authors.lastname: Inui
authors.forename: Mikio
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kakehi
mesh_terms: D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects*; D006505:Hepatitis / Q000209:etiology*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D017563:Lung Diseases, Interstitial / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000628:therapy
chemical_list: D001500:BCG Vaccine