[Miliary dissemination with pulmonary involvement secondary to intravesical immunotherapy with Calmette-Guérin bacillus]. / Diseminación miliar con afectación pulmonar secundaria a inmunoterapia intravesical con bacilo de Calmette-Guérin.

We describe the case of a 67-years-old man who underwent transurethral resection and immunotherapy with Calmette-Guérin bacillus solution (CGB) for superficial transitional carcinoma of the bladder. After a series of intravesical irrigations with CGB, the patient developed fever, asthenia and persistent anorexia and was hospitalized. After testing he was diagnosed of miliary tuberculosis due to CGB and died in spite of tuberculostatic therapy. Hematogenous dissemination, a rare but serious complication of vesical irrigation with CGB, is thought to be more common than previously suspected. It should be suspected in all patients receiving CGB when a compatible clinical picture presents. An understanding of this complication and early establishment of specific treatment is the only wat to improve prognosis.

[Pleural cholesterol: a useful determination]. / Colesterol pleural: una determinación útil.

The difference between exudates and transudates is the first question a clinician must solve when facing a pleural effusion. A great number of parameters have been tried without a definite efficacy of any of them. Cholesterol is an easy, useful determination for distinguishing exudates from transudates. In our series of 86 patients a cholesterol value of 50 mg/dl allowed us to correctly classify 94.2% of effusions. The ratio between pleural fluid cholesterol/serum cholesterol was more efficient because it permitted to correctly classify 97.7% of effusions, in one of those major groups which constitute the binomial exudate/transudate.