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1
An 81-year-old man with high-grade urothelial carcinoma presented with malaise, weakness, fatigue, and subjective fevers after 5 months of atezolizumab and tiragolumab therapy.
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2
His medical history included stage 4 chronic kidney disease, gout, asthma, and a prior left lung adenocarcinoma resected 9 years earlier.
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3
Initial antibiotic treatment for possible epididymitis failed to improve his symptoms, raising concerns for infection, autoimmune conditions, or recurrent malignancy.
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4
CT imaging revealed right-upper-lobe centrilobular nodules and mild pulmonary edema, prompting consideration of infection or drug-induced pneumonitis.
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5
Despite negative cultures and resolved fevers, the patient preferred discharge after 6 days, with ongoing malaise and generalized weakness.
