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While published cases have been pathologically characterized by multiple granulomatous lesions due to disseminated infection,\n no case presenting as a solitary pulmonary nodule has been reported.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A man in his 70\u00a0s was treated with intravesical BCG for early-stage bladder cancer. After 1\u00a0year, he complained of productive cough with a solitary pulmonary nodule at the left lower lobe of his lung being detected upon chest radiography. His sputum culture result came back positive, with conventional polymerase chain reaction (PCR) identifying <jats:italic>Mycobacterium tuberculosis<\/jats:italic> complex. However, tuberculosis antigen-specific interferon-gamma release assay came back negative. Considering a history of intravesical BCG treatment, multiplex PCR was conducted, revealing the strain to be <jats:italic>Mycobacterium tuberculosis<\/jats:italic> var. BCG. The patient was then treated with isoniazid, ethambutol, levofloxacin, and para-aminosalicylic acid following an antibiotic susceptibility test showing pyrazinamide resistance, after which the size of nodule gradually decreased.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This case highlights the rare albeit potential radiographic presentation of <jats:italic>Mycobacterium tuberculosis<\/jats:italic> var. BCG, showing a solitary pulmonary nodule but not multiple granulomatous lesions, after intravesical BCG treatment. Differentiating <jats:italic>Mycobacterium tuberculosis<\/jats:italic> var. BCG from <jats:italic>Mycobacterium tuberculosis<\/jats:italic> var. <jats:italic>tuberculosis<\/jats:italic> is crucial to determine whether intravesical BCG treatment could be continued for patients with bladder cancer.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-021-01475-w","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T12:03:19Z","timestamp":1617796999000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A solitary pulmonary nodule caused by Mycobacterium tuberculosis var. 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