{
  "abstract": "IntroductionPembrolizumab-based bladder preservation strategies are increasingly applied in invasive high-grade urothelial carcinoma, yet checkpoint inhibitor pneumonitis (CIP) remains an underrecognized, potentially fatal adverse event. Diagnosis can be markedly delayed when concurrent infection is present.Case presentationA 63-year-old man with invasive high-grade urothelial carcinoma developed complete tumor response after receiving disitamab vedotin plus pembrolizumab following chemotherapy intolerance. He subsequently presented with urinary tract infection and septic shock. Aggressive anti-infective and hemodynamic support promptly reversed shock and normalized systemic inflammatory markers. Nevertheless, follow-up chest computed tomography demonstrated persistent bilateral ground-glass opacities and consolidation without any improvement. Pre-treatment chest radiography had been normal, positron emission tomography–computed tomography showed marked bilateral pulmonary fluorodeoxyglucose uptake without bladder recurrence, and extensive microbiological workup excluded uncontrolled infection. The dissociation between well-controlled infection and stationary pulmonary lesions, together with typical imaging features, raised strong suspicion of pembrolizumab-induced CIP.ConclusionIn patients receiving PD-1 inhibitors, persistent pulmonary infiltrates despite effective anti-infective therapy should raise strong suspicion of checkpoint inhibitor pneumonitis and prompt dedicated diagnostic evaluation. This phenotype—the dissociation between resolving systemic infection and stationary lung lesions—may serve as a practical clue to consider CIP earlier, particularly when invasive diagnostic tools are unavailable; however, it is a suggestive rather than confirmatory finding and requires validation in larger cohorts.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Case Report",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "name": "Li Zhao"
    },
    {
      "name": "Yeming Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5h0psygsng5t1.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1898019",
  "fulltext_url": null,
  "id": "5h0psygsng5t1",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1898019",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "medicine/oncology"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5h0psygsng5t1.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T06:20:07Z",
      "native_id": "10.3389/fonc.2026.1898019",
      "source": "feed-frontiers",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1898019"
    },
    {
      "first_seen": "2026-11-06T12:21:22Z",
      "native_id": "10.3389/fonc.2026.1898019",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1898019/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "feed-journal:medicine/oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Persistence of pulmonary infiltrates despite effective anti-infective therapy as a diagnostic clue for pembrolizumab-induced pneumonitis: a case report",
  "title_text": "Persistence of pulmonary infiltrates despite effective anti-infective therapy as a diagnostic clue for pembrolizumab-induced pneumonitis: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T00:23:06Z",
  "url": "https://research.draconitic.com/paper/5h0psygsng5t1",
  "venue": "Frontiers in Oncology",
  "versions": []
}