Acute Tuberculosis Infection Concomitant with Nivolumab Treatment in a Patient with Non-small Cell Lung Cancer: A Case Report and Review of the Literature

Author(s) :

 Edvina E. Pîrvu1, Cristina E. Cocioabă1

  1. 1Medical Oncology Department, Colțea Clinical Hospital, Bucharest, Romania

Corresponding author: Edvina E. Pîrvu , Email:

Published: Volume II, Issue 2, December 2022, 59-65, , , - DOI: 10.53011/JMRO.2022.02.09

Open Access

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December 1, 2022 0 Comments


Nivolumab, a fully human immunoglobulin G4 (IgG4) monoclonal antibody PD-1 immune checkpoint inhibitor  and other immune checkpoint inhibitors are used to promote activation of anti-tumor immuno response in the fight against cancer.  Recently published case reports raised awareness on a particular adverse effect of immunothrapy:  reactivation of latent Mycobacterium tuberculosis infection. This case report describes a 67-year old Caucasian male who presented with concomitant tuberculosis infection of the pleura and pericardium with nivolumab therapy for non-small cell lung cancer. He received antituberculous treatment, with favorable evolution. With no available guidelines for the management of tuberculosis during PD-1/PD-L1 blockade, a high index of suspicion should exist when the evolution of the patient takes an unexpected turn. This approach should be applied especially in countries with a high incidence of tuberculosis.

Figure.1 CT Exam at Diagnosis Showing a Mass in the Apex of the Right Lung.
Figure. 2 CT Exams Comparing the Pulmonary Mass at Diagnosis (right) and the Pulmonary Mass after Chemoradiation (left).
Figure. 3 CT exam Showing Pleurisy and Pericardial Effusion After the Initiation of Treatment with Nivolumab.
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